Legislation: Pre-legislative Scrutiny
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	Question

Lord Campbell of Alloway: To ask Her Majesty's Government whether drafts of all their Bills should be subject to pre-legislative scrutiny.

Lord Strathclyde: No, my Lords. Although we are committed to bringing forward as many draft Bills as possible, it is not always possible to do so-for instance, where Bills have deadlines for Royal Assent. This Session, the Government will publish in draft at least four Bills.

Lord Campbell of Alloway: I thank my noble friend the Leader of the House for having taken this Question, which has constitutional effect. May I, by leave, ask two questions for clarification? What consideration have the Government given to the three group reports that favoured mandatory reforms of pre-legislative scrutiny of draft government Bills, as was spoken to-I see the noble Baroness, Lady Royall, looking at me-on three occasions: 25 January, 28 February and 12 July? The other question is very short: to ask whether and, if so, when a new formal, wholly effective structure shall be set up?

Lord Strathclyde: My Lords, my noble friend is entirely correct that this is an important issue. For some years now there has been good practice from the former Government and this Government in attempting to publish Bills in draft and apply a process of pre-legislative scrutiny. The reason why there is not a mandatory structure for this is in part that it is not possible to have formal pre-legislative scrutiny early on in the Parliament. Some departments, through the process of consultation and the publication of Green Papers and White Papers, already allow for a certain element of pre-legislative scrutiny, although not necessarily the one preferred by my noble friend.

Lord Grenfell: My Lords, will the noble Lord the Leader of the House concede that pleading resource constraint does not constitute a credible argument against publishing as many Bills as possible in draft? Does he recall what the Liaison Committee in another place concluded in 2001 in its report, Shifting the Balance: Unfinished Business? It said:
	"We repeat our view that the benefits in terms of better thought out and properly examined legislation will be out of all proportion to the modest expenditure involved".
	Is that not still true today?

Lord Strathclyde: My Lords, I had not yet raised the question of resources. Although resources count, they should not necessarily be the be-all and end-all of the subject. I do not wish to give the impression that the Government are in any way opposed to pre-legislative scrutiny. We are committed to it; it improves the quality of legislation and provides an opportunity for public engagement. We have a group, chaired by my noble friend Lord Goodlad, looking at working practices, and I know for a racing certainty that this is one of the issues that it will be looking at.

Lord Maclennan of Rogart: My Lords, I recognise my noble friend's role in engaging with our Liaison Committee in this House, but would the Government be prepared to invite Members of both Houses to consider the wise recommendations of the Constitution Committee, as far back as 2004, that the two Houses should establish a Joint Liaison Committee so that the opinions and particular expertise of this House could be fully taken into account in considering whether or not to establish Joint Committees for pre-legislative scrutiny?

Lord Strathclyde: My Lords, there is no bar to Joint Committees of both Houses being involved in pre-legislative scrutiny. We have already proposed that, this Session, there should be a Joint Committee on pre-legislative scrutiny when a draft Bill is published on the future of your Lordships' House. Whether there should be a formalised structure of a Joint Liaison Committee is another matter altogether, and one that I am certainly prepared to consider.

Baroness Royall of Blaisdon: My Lords, does the noble Lord the Leader of the House agree that it is especially important that constitutional Bills have pre-legislative scrutiny? I recognise the difficulties he cited about it being early in this Parliament, but might he not regret the fact that the Parliamentary Voting System and Constituencies Bill came so early in this Parliament? That is a Bill that should have been subject to pre-legislative scrutiny. May I also suggest to him that the public bodies Bill should be subject to pre-legislative scrutiny? There has been little or no consultation on it but it will affect millions of our citizens.

Lord Strathclyde: My Lords, I do not agree with either the general premise of the noble Baroness's argument or the specific examples. The Parliamentary Voting System and Constituencies Bill was published on 22 July and the Committee stage in another place did not begin until October. So there was plenty of time, albeit there was a Summer Recess, for it to be examined.

Lord Norton of Louth: My Lords, does my noble friend agree with me that there should be a presumption in favour of pre-legislative scrutiny? Does he think it desirable that if a Bill is brought forward without pre-legislative scrutiny, the Minister sponsoring the Bill should at least make a Statement to Parliament explaining why the Bill has not been so subject?

Lord Strathclyde: My Lords, I am sure that my noble friend will find as the Parliament gathers pace that there are more and more Bills for pre-legislative scrutiny. I made the case at the beginning that-in the very first Session of a Parliament, particularly when many of the ideas we are bringing forward were tested at the anvil of election and, indeed, while we were in opposition-it would be unfair to have a mandatory basis for pre-legislative scrutiny.

Lord McFall of Alcluith: My Lords, perhaps I may remind the Government of a Bill that they introduced early in the 1992-97 Parliament-a raves Bill dealing with the tragic deaths of young people in nightclubs in Scotland. It was a three-clause Bill and we subjected it to pre-legislative scrutiny. The major clause was the third one. The then Minister, after the pre-legislative scrutiny and the visits we made, informed me that the Government were withdrawing that clause. Does that not tell us that Parliament, left on its own, can foul up in the most magnificent way, and therefore that the need for pre-legislative scrutiny of every Bill is urgent?

Lord Strathclyde: My Lords, I totally agree with the broad thrust of the noble Lord's argument-that pre-legislative scrutiny is important and useful. The noble Lord is also right. If you look at many of the Bills that were passed over the last 13 years, you wonder how many of them would have been improved with a bit more pre-legislative scrutiny.

Armed Forces: Refusal of Goods and Services
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	Question

Lord Craig of Radley: To ask Her Majesty's Government what steps they are taking to ensure that members of the Armed Forces are not discriminated against in the provision of goods and services in the United Kingdom, particularly while wearing their uniform.

Lord Astor of Hever: My Lords, our Armed Forces are currently deployed to the most demanding areas of conflict to maintain our national security. I am sure the whole House will agree that there is no place for those who, without good reason, refuse to provide goods and services to service personnel wearing uniform. Where incidences do occur, it is mostly a local issue. Commanding officers have been given guidance on suitable action to resolve matters, based on engagement with the local community.

Lord Craig of Radley: I thank the Minister for that reply. He will have seen examples in news reports of servicemen in uniform being refused service, either in a hotel or when buying something in a supermarket. Is it not the case that the MoD now encourages servicemen to wear uniform? Are there any other such cases of unsuitable behaviour and discrimination being reported up the command chain? In opposition the Conservative Party talked about increasing the strength of the military covenant. Would this be a suitable vehicle for dealing with such discrimination?

Lord Astor of Hever: My Lords, we encourage servicemen and women to wear uniform as much as possible. I am aware of the small number of incidences that were reported in the media, including the two mentioned by the noble and gallant Lord. All of us will remember the scenes and demonstrations in Luton during the homecoming parade of the Royal Anglian Regiment. Behaviour of this kind is unacceptable, but, in truth, it is rare, and the vast majority of the public support our Armed Forces enthusiastically. With regard to the noble and gallant Lord's question on the covenant, we are looking carefully at the best way of ensuring that the covenant makes a real difference and that the Armed Forces community gets the respect and services it deserves. That means looking at all options, including legislation.

Lord Addington: My Lords, does my noble friend agree that if we are going to support people who are putting their lives on the line for our country, we should give them all the support we possibly can? Will he clarify to the House exactly what the legal status is if somebody is refused a service just because they are wearing the uniform of one of Her Majesty's services?

Lord Astor of Hever: My Lords, legislation would not necessarily address the problem, but we encourage commanding officers to engage as much as possible with the local community to prevent the sort of incident that my noble friend mentioned.

Lord Anderson of Swansea: My Lords, does the Minister agree that publicity, shame and possible boycotts might be the most effective remedy for this? If, as he says, the Government are considering legislation, what form might that legislation take?

Lord Astor of Hever: My Lords, the Government recognise the need to do more to ensure that our Armed Forces, veterans and their families have the support they need and are treated with the dignity they deserve. We are working on the covenant at the moment. It will be a new tri-service document setting out key, enduring general principles which can be applied to particular problems as they arise. It will be accompanied by more detailed material on what the service community can expect to see delivered.

Lord King of Bridgwater: My Lords, is it true that one of the incidents referred to by the noble and gallant Lord, Lord Craig, might have taken place in a supermarket? Can my noble friend confirm that the leadership and boards of directors of all the major supermarkets in this country are quite clear in the instructions and advice that they give to all their employees? If that is not being done, I hope the Ministry of Defence will address it and make sure that they play their part in ensuring that the covenant is fully observed.

Lord Astor of Hever: My Lords, I can give my noble friend that assurance. They are well aware of the issues here.

Baroness Howarth of Breckland: My Lords, while deeply regretting these incidents, could we not also celebrate those places where our Armed Forces are welcomed? As someone who lives near Thetford, in the middle of a battle area and near two Air Force bases, I often see our forces in our local stores, where they are very welcome. So we should regret this situation but also recognise that, across the country, many people rejoice in welcoming our Armed Forces.

Lord Astor of Hever: My Lords, I agree entirely with every word that the noble Baroness said.

Lord Richard: My Lords, further to an answer that the noble Lord gave a few moments ago, is it suggested that the military covenant should now have legislative force? Should it become an Act? How does he see it in the future?

Lord Astor of Hever: My Lords, we are looking at all kinds of options and hope to come forward with something either at the end of this year or early next year. We have not decided whether it will be part of the Armed Forces Bill, but we are looking at the issue.

Viscount Brookeborough: My Lords, I know that the Minister is aware of the situation for veterans and soldiers in civilian clothes as regards accessing medical care, but this is an issue within the Government's control. Why is it that many GPs and GP practices are not aware of the fast-track assistance for soldiers and veterans, and why is it that we can track cattle and animals throughout Europe but we do not know where our veterans are?

Lord Astor of Hever: My Lords, the noble Viscount and I have had a number of discussions on this issue, and it is an issue that we take very seriously. I hope to come back to him with more positive news on it soon.

Taxation: Deficit Reduction
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	Question

Lord Lea of Crondall: To ask Her Majesty's Government how far they expect increased income tax and corporation tax revenues to contribute to the reduction of the deficit.

Lord Sassoon: My Lords, the Office for Budget Responsibility's Budget forecast shows that income tax receipts are forecast to be 10.2 per cent of GDP in this fiscal year and 11 per cent of GDP in 2015-16. The OBR has forecast corporation tax receipts to be 2.9 per cent of GDP this fiscal year and 3.2 per cent of GDP in 2015-16.

Lord Lea of Crondall: My Lords, I thank the Minister for that reply but I hope that I may translate his figures into actual cash. Will he confirm that the Red Book, which fully anticipated the cuts announced last week, states that, as compared with the Labour Government's plans, there will be a reduction in income tax and corporation tax revenue each year until 2014, when the cost will be £5 billion, and that is on top of another £5 billion as a result of lower national insurance contributions from employers? That adds up over the period to no less than £40 billion. Will he also confirm that that £40 billion is additional to the direct Exchequer cost of extra unemployment payouts, forecast by the Office for Budget Responsibility to be higher in every year through to and including 2014, as compared with the Labour Government's plans?

Lord Sassoon: My Lords, as compared with the Labour Government's plans, an awful lot of things have changed. The first is that we have a credible deficit reduction plan. We have yet to hear the Opposition's plans on that. There will be a reduction in public spending of £81 billion by 2014-15, but, critically, we need growth, and so 77 per cent of the deficit reduction plan will come out of a reduction in spending. We absolutely want to keep the pain of increased taxation to a minimum. That is why it is absolutely critical and right that our taxation plans aim for lower revenue than do the Opposition, because that is what is required to get growth in the economy going.

Lord Forsyth of Drumlean: My Lords, will my noble friend confirm-as I think the noble Lord, Lord Myners, did before the election-that the actual revenue from increasing the top marginal rate of tax to 50 per cent is very much less than was anticipated? Is that the case? Will he also confirm that the lesson of the 1980s, and of the experience of other countries around the world, is that if you want the rich to pay more in taxes, you do that by cutting rates, not increasing them?

Lord Sassoon: I am very grateful to my noble friend. I completely agree with his sentiments. This is not a Government who believe in medium and long-term high marginal rates of taxation. We have to incentivise the private sector to go out and generate wealth in order to deal, among other things, with the rebalancing of the economy which is now so necessary.

Lord Howarth of Newport: My Lords, does the noble Lord really expect us to believe that engineering a wholesale reduction in demand in the economy is the way to prepare for growth? Will the noble Lord be candid and say whether he considers that the Government are more politically vulnerable on account of their failure to provide growth, or of their failure to provide fairness?

Lord Sassoon: My Lords, I will cite the latest figure this week for quarterly growth in the economy. The naysayers said that growth in the last quarter would be 0.4 per cent, but it was 0.8 per cent, coming on top of 1.2 per cent in the previous quarter. With more than 300,000 new private sector jobs created in the second quarter, that is the way in which we will deal with the economic situation.

Lord Newby: My Lords, I am sure that the whole House will welcome the announcement this week of an agreement between the UK and Switzerland to tax adequately for the first time bank accounts held in Switzerland by UK citizens. Will the Government press for these accounts to be taxed at 50 per cent, equivalent to what these people would be paying on their income if they were living here and their accounts were here?

Lord Sassoon: I am grateful to my noble friend for drawing attention to the fact that the Government have made a very significant breakthrough in combining the need to get proper tax receipts for bank accounts held in Switzerland with the Swiss Government's understandable concern about banking secrecy. We will have to wait and see what the final details are, but it is a major breakthrough.

Lord McKenzie of Luton: My Lords, will the Minister update us on the issue of anti-avoidance provisions, and in particular general anti-avoidance provisions? The June Budget book says that the Government will engage informally with interested parties. Does not engaging informally display a certain lack of seriousness? Will the noble Lord share with us who these interested parties might be? Are they the big law firms, the big accountancy firms, the non-dom community or the international banks?

Lord Sassoon: We are consulting widely in the way that is described and we will come forward with proposals in due course. In the mean time, we have allocated an additional £900 million of expenditure to HMRC over the spending review period, which is expected to result in annual revenue increments of £7 billion by the end of that review period. We are taking action very quickly in this area-much more so than did the previous Government.

Lord Tebbit: My Lords, will my noble friend choose his words a little more carefully at times? Is it not a fact that in every year through the period of this public expenditure survey, public expenditure will increase and not reduce?

Lord Sassoon: My Lords, I will try to be very careful with my wording and simply agree absolutely with what my noble friend has said.

Lord Davies of Oldham: My Lords, the Minister is responsible for the efficiency of his department and he will know the calamitous position that Her Majesty's Revenue and Customs was in earlier this year with regard to the settlement of our fellow citizens' taxation matters. How does the Government's proposed determination to tackle tax evasion and avoidance square with a determination to cut 13,000 posts in HMRC over the next few years?

Lord Sassoon: My Lords, I have already explained to the House that we are targeting considerable extra resources where it matters in order to get in extra revenue. That is critical. The noble Lord talks about the calamitous position, but where did the calamitous position arise from? This is the result of an exercise to bring forward and modernise the reconciliation systems in our income tax system, which has been sorely needed for quite a few years.

Baroness Farrington of Ribbleton: My Lords, will the Minister comment on the fact that the latest growth figures are based primarily on the previous Government's policies rather than those of the current Government? Will he also comment on the widespread concern that the figures that the Government give for growth-for example, the per pupil figures in the education budget-are at times slightly deceptive? The Government take no account of the increase in pupil numbers, and therefore the amount being spent per pupil is actually being cut in real terms.

Lord Sassoon: In answer to the first question, no. In answer to the second question, the independent Office for Budget Responsibility will be presenting its updated assessment of the numbers post the spending review on 29 November.

Broadcasting: S4C
	 — 
	Question

Lord Roberts of Llandudno: To ask Her Majesty's Government what assurances they can give that the Welsh language channel S4C will be adequately financed following the proposed new funding arrangement with the BBC.

Baroness Rawlings: My Lords, the Government want to make certain that S4C offers the best possible language service to its audience, and feel that the best way to secure its future while delivering a better service is through partnership with the BBC. From 2013-14, therefore, the cost of S4C will be met from a combination of continued Exchequer funding, advertising revenue and the licence fee.

Lord Roberts of Llandudno: I thank the Minister for that reply. First, do the Government realise how vital S4C-the only Welsh language channel-is to the Welsh people? Secondly, can I have an assurance that by 2015 the service provided in the Welsh language by S4C will not be diminished but will be as secure and comprehensive as it is at present?

Baroness Rawlings: My Lords, my noble friend Lord Roberts and many of your Lordships involved with Wales mind passionately about S4C, and he is right to raise the issue. I hope I can assure my noble friend and the House that its funding is secure for the next four years. This will enable S4C to structure itself for the modern broadcasting environment and, importantly, it will retain its commercial freedom.

Lord Morris of Aberavon: My Lords, does that not mean that there will be less money for Welsh television year by year? Because of the dangers of the BBC exercising too much influence in the new arrangements, will the Government assure us that there will be firm guidelines regarding the relationship in the new partnership?

Baroness Rawlings: My Lords, the noble and learned Lord is right, and that point has been brought up many times. The exact level of funding is not yet set beyond 2014-15. While future funding will reflect overlaps and efficiencies, it will remain consistent with the commitment to a strong and independent Welsh language TV service.

Lord Elystan-Morgan: My Lords, does the noble Baroness accept that the position of the Welsh channel is wholly unique? Does she appreciate that this channel was established 28 years ago after a long and bitter campaign of civil disobedience and law-breaking in Wales, and that although Parliament has the right to change the legislative structure which was set up to protect and preserve the Welsh language, to do so would mean reneging on a compact made between the Home Secretary of the day, the late William Whitelaw, and the Welsh people?

Baroness Rawlings: I agree with the noble Lord that it is unique. That is important and it is why the Government have stressed that S4C should continue to be properly funded. A new governance structure will be required to deliver the partnership with the BBC. The BBC Trust and the S4C Authority will need to agree jointly the strategic goals and broad editorial requirements and hold S4C to account for their delivery. This structure will be up and running by 2012-13.

Lord Roberts of Conwy: My Lords, can the Minister confirm that the agreement which her department concluded with the BBC over the part-funding of S4C ensures the continued independence of S4C within the partnership as regards commissioning programmes from independent producers and raising revenue from advertising? Can she further confirm that legislation will be needed to effect the change in S4C funding, which is currently subject to statute?

Baroness Rawlings: My Lords, my noble friend Lord Roberts of Conwy is of course right, and he naturally feels strongly about S4C because, after all, he started it. I can assure him that S4C will remain a unique entity and retain its editorial independence under the partnership. The intention is that the public bodies Bill will effect the change in S4C's funding by breaking the current automatic funding link with the RPI. He is also right to say that it is important that the programmes for the channel are 100 per cent independent.

Lord Hunt of Kings Heath: My Lords, the noble Baroness has said that she cannot give undertakings on funding beyond 2014-15. However, under the commitment that she has given today, can she commit that the Welsh language channel will continue beyond those years, and that it will be adequately financed?

Baroness Rawlings: My Lords, we have been consulting on this very important point, which many people have raised. We fully recognise the iconic status of the channel and the contribution that it makes to cultural and economic life in Wales. The last census showed that, since S4C started, there has been a 3 per cent increase in Welsh speakers in Wales. As well as sustaining and promoting the Welsh language, the channel provides a focal point for the celebration of Welsh national events. That is why we are financially securing S4C's future.

Black Rod
	 — 
	Announcement

Lord Strathclyde: My Lords, I am sure that the House will wish to know that the Lord Speaker and the Clerk of the Parliaments have received a letter from Sir Freddie Viggers announcing his decision to resign as Black Rod. Black Rod, or Sir Freddie as we have come to know him, continues to make a remarkable recovery from a serious illness in May. However, I am sure that the House will respect his decision to resign, which I know he made with great reluctance.
	This is not the moment for the House to pay tributes. As is customary, the House will have the opportunity to express its appreciation to Sir Freddie for the excellent service that he has given as Black Rod when his successor is appointed by the House. Until the appointment is made, the House will be grateful to the Yeoman Usher, Lieutenant Colonel Ted Lloyd-Jukes, for continuing as acting Black Rod.
	Finally, on behalf of the whole House, the Lord Speaker has written to Sir Freddie, sending him very best wishes for a continued recovery and to his wife Jane and family.

Public Bodies Bill [HL]
	 — 
	First Reading

A Bill to make provision for conferring powers on Ministers of the Crown in relation to certain public bodies and offices, to confer powers on Welsh Ministers in relation to environmental public bodies, to make provision in relation to forestry, to make provision about amendment of Schedule 1 to the Superannuation Act 1972; and for connected purposes.
	The Bill was introduced by Lord Taylor of Holbeach, read a first time and ordered to be printed.

Freedom of Information (Time for Compliance with Request) Regulations 2010

European Communities (Definition of Treaties) (Central Africa Interim Economic Partnership Agreement) Order 2010

European Communities (Definition of Treaties) (Côte d'Ivoire Economic Partnership Agreement) Order 2010

Disabled People's Right to Control (Pilot Scheme) (England) Regulations 2010

Asylum (First List of Safe Countries) (Amendment) Order 2010

Immigration (Biometric Registration) (Amendment) Regulations 2010
	 — 
	Motions to Refer to Grand Committee

Moved By Lord Strathclyde
	That the draft orders and regulations be referred to a Grand Committee.
	Motions agreed.

Business of the House
	 — 
	Timing of Debates

Moved By Lord Strathclyde
	That the debates on the motions in the names of Baroness Perry of Southwark and Lord Hunt of Wirral set down for today shall each be limited to two and a half hours.
	Motion agreed.

Education: Pupils and Young People
	 — 
	Debate

Moved By Baroness Perry of Southwark
	To call attention to the case for providing excellence in education for all pupils and young people; and to move for papers.

Baroness Perry of Southwark: My Lords, I am pleased to have the opportunity to debate this important topic today. I look forward very much to hearing the contributions of so many noble Lords who I know share my passion for raising standards in our schools and colleges. I say a particular thank you to the Minister, who has bravely come to take part in our debate today, despite having had the awful experience of being mugged-quite severely, as I understand it-on his way home last night. I know that the whole House will wish to join me in giving him our thanks for being here, our sympathy and our very best wishes.
	The history of our nation's search for the holy grail of "every school a good school" has been both long and so far, sadly, unsuccessful. Nearly 70 years ago, the great Education Act of 1944 set the goal of every child to be entitled to education suited to their "age, ability and aptitude". That goal, also, has so far not been attained.
	Let me reflect on the task that we have yet to complete for at least three groups of our young people. First, far too many bright children from disadvantaged backgrounds receive an education that is far below their ability. Secondly, far too many young people are forced into a mould of education unsuited to their interest or aptitude. Thirdly, far too many exceptionally gifted children-perhaps most particularly those gifted in the sciences-are insufficiently challenged by the education that they receive. Tragically, for them and for our country, some young people in all three of those categories fall by the wayside.
	Consider first the bright children from poor backgrounds. Fewer than half as many pupils who are eligible for free school meals achieve the magic five good GCSEs as do their better-off contemporaries. The gap between the poorest-achieving schools and the best is shocking. Last year, at the bottom, 138 schools failed to achieve five good GCSE passes for even 20 per cent of their pupils. Meanwhile, the top 184 schools achieve that success for more than 90 per cent of their pupils. The sad fact is that those worst-achieving schools were almost always found in areas of social deprivation. In Britain today, where you live, more than any other factor, determines your access to good education. League tables of school achievement simply tell you where rich people live. If we could abolish catchment areas, that might help, although it would create other injustices and is in practical terms unworkable.
	What every parent wants and every child deserves is a good neighbourhood school. That is why the academies programme is so important and why it offers the greatest prospect of lifting the standards of schools in the areas of greatest need. I here pay tribute to the previous Government and especially to the noble Lord, Lord Adonis, for introducing the academies programme, which built on and extended Lord Joseph's city technology college vision. The Academies Act introduced by the coalition Government, which occupied many hours of time in this House before the Summer Recess, took that vision further and expanded the freedoms of academies, allowing them better to serve their pupils' and parents' needs. Add to that the introduction by the coalition Government of a pupil premium for children on free school meals and the prospect of at last offering the poorest children excellence in education is in sight.
	Perhaps more controversially, we need to address the many young people currently forced into a mode of education unsuited to their talents and interests. There are still some who believe that all young people should be forced into an academic education right through their schooldays. Under the previous Government, schools and teachers had been judged by their pupils' achievement on written tests and examinations. Targets of 50 per cent of young people entering higher education reflected their fixed belief in the academic mould, although, on examination, this belief seems perverse. It fails to take into account the country's need for well educated and skilled craftsmen and technicians, while also failing to take into account the simple fact that many young people are uninterested in academic achievement but have motivation and talent in the technical and vocational areas.
	The previous Government's introduction of diplomas was the first effort to recognise that-I again pay tribute to them for it-but the criteria for those diplomas was too often academic and schools that offered them did not always provide the vocational expertise and the links to employers that were needed for them to succeed. I am delighted that the coalition Government are increasing the number of apprenticeships and I hope that employers will respond, even in these hard times, by providing the hands-on work experience that motivates the apprentice and provides her or him with valuable practical skills. If we are to provide for all the talents and skills of our young people, this area still needs to be addressed with some urgency.
	Thirdly, we need to do far, far more to meet the needs of the exceptionally gifted children, on whose talents will rest much of the future success of business, innovation, public service and academic discovery. In recent years, under the mistaken policies of the previous Government, it has appeared almost sinful to allow the natural spread of talent in the population to be reflected in the outcomes of education. A levelling down of expectations and achievement so that no pupil outshone the rest became mistakenly accepted as evidence of social inclusion.
	As a consequence, the leading universities found that they could no longer trust the results of A-level examinations which promised outstanding results to a majority of young people. They found gifted scientists who suffered from a lack of any rigour in their understanding of the disciplines of physics or chemistry, with the result that these top universities have now turned to separate examinations that test the skills of the most gifted and have provided special coaching to bring 19 year-olds up to the required standard in maths and even in written English. What an indictment of what these highly gifted young people's education has provided for them.
	Gifted children have special needs, just as do those with learning difficulties, and they need nurturing and developing in ways that too many of our state schools have failed to offer. Providing for the needs of every child means accepting that equality of opportunity-for which I will fight as long as I have breath-does not imply equality of outcome. Some children run faster; some are prettier; some are taller; and some are better footballers, better musicians or better scientists than others. Education that allows all these talents to develop to their fullest extent should be our ultimate goal.
	Changing the structure of school or curricula offerings, while necessary, is not a sufficient condition for excellence. The quality of experience for every child is determined most of all by the teachers whom she or he encounters. The quality of teachers is now probably the best that it has ever been in terms of their education and qualifications. I celebrate the emphasis that our coalition Government have given to taking away the top-heavy load of surveillance, regulation, bureaucracy and suspicion, which has stifled the professionalism of teachers in recent times.
	Trusting heads and teachers to make the best professional judgments about how to serve the needs of their pupils is an essential way of ensuring that every child has the right education for their abilities and aptitudes. As professionals, heads and teachers can be trusted to judge the right kind of disciplinary regime for their cadre of pupils. They are also best placed to judge the right mix of academic and vocational offerings to meet their pupils' needs and interests.
	Teachers and heads would, however, be the first to agree that their increased autonomy must be balanced by the right kind of accountability. National league tables are not the answer, although every parent has the right to know how a secondary school in their area is performing in national examinations or how a primary school close to them is performing in test results at the end of the primary stage. National results are of comparatively little value to the parent trying to choose the best school for their child. Schools must, however, make publicly available the maximum information to their local community in order to inform choice.
	Robust inspection that bears on excellence is a vital ingredient in accountability. I am sad to have to say that in recent years Ofsted has failed to perform this necessary function. It is not Ofsted's fault. It has been required by the previous Government to perform a multitude of functions, many of which have only marginal relationships to good education. It ticks boxes on predetermined standards of health and safety. True stories are told, for example, of a school failing and being put into special measures because its safety fence was not quite high enough. It ticks boxes on measures of inclusiveness and social diversity. What has that to do with educational outcomes? When it comes to education matters, Ofsted ticks its boxes on inputs, availability of resources, buildings, furniture and teachers' lesson plans. The output that it reports is mainly the test and examination results, which are already publicly available. On the basis of these ticks in boxes, parents and employers are told whether a school is failing, succeeding or just jogging along at the margin.
	This is not, in my view and that of many others who care about raising standards, what inspections should be about. Inspections should be a careful, professional assessment of what teachers and schools are doing to ensure their pupils' success. Are they motivating and inspiring? Are they fostering curiosity? Are they providing a rich diet of learning that is appropriate to the background and ability of each pupil? However they are achieving this, their success should be noted and reported regardless of whether they are obeying the diktats of some central regulation. If they are failing to inspire-and, indeed, not all teachers, schools or heads are doing a good job-the priority is to work with them, to give them the skills and support to perform better, not to name and shame. Naming and shaming does not by itself raise standards. It has a disastrous effect on the children and young people in the school, as well as on the careers of all the teachers in the school, some of whom may well have been working hard to give the best that they can to their pupils.
	More important than naming and shaming is working for school improvement. That is an expert task and only the most senior people with a proven record of success are qualified to undertake it. It is the most essential way in which the accountability of schools, heads and teachers can be turned into success for the children in their care. That is what inspection must achieve.
	I wish more than anything to see our schools and colleges offering excellence in education to all children and young people. To achieve this goal, the creation of academies, the pupil premium and the enhancement of autonomy to heads and teachers have already been put in place by the coalition Government. I celebrate and welcome that. We are still to consider a system of inspection that marks success and works to turn failure into growth. That, too, is an essential ingredient. I believe that all these are within our grasp. I beg to move.

Baroness Morris of Yardley: My Lords, I welcome the debate and congratulate the noble Baroness, Lady Perry, on introducing it. She always does so in a thoughtful and sensible way and I enjoy listening to and debating with her, as I do this morning.
	She has highlighted some of the issues that still need to be addressed. I do not differ from her and I am not going to go over them. However, I should like to place on record the improvement there has been in our school system over recent years. Certainly I remain proud of the achievements under the previous Government-we made a wise investment-but I am not blind and I know that there is work still to be done. It will be more difficult to do at a time of falling budgets but that is the situation we are in.
	We do not have a great deal of time and I wish to concentrate my comments on one specific matter. One of the strands that outlines the coalition's approach to school improvement-I agree that it is a key issue-is the devolvement of power to teachers, trusting professionals and teacher autonomy. The noble Baroness, Lady Perry, said that that is not enough; that there needs to be an accountability mechanism as well. I wish to challenge that because I do not buy into it. I am second to none in my admiration for teachers and the work they do and I, too, believe that we have the best generation of teachers we have ever had. I trust most of them but I do not trust all of them-and I probably do not trust any of them all the time. That is human nature and would be the same with any profession.
	There was a time when we trusted teachers to get on with it-the days when I started teaching-but, to be honest, the quality of teaching was poorer and the outcomes and results for children were weaker than they are now. It is an easy thing to say-it sounds good and will certainly put you in the good books of teachers-but, for me, it is not the way to school improvement. Two things have to happen: I trust teachers if I know that they are working within a framework of challenge and high-quality support; I do not trust teachers if they are left to get on with it themselves. I want to consider both of those issues in the time remaining.
	If teachers are taking decisions about which pedagogy to use, how to group children, what reading scheme to use, what the balance of vocational and academic work should be, I would like to think that there was an evidence base to which they could refer when making those decisions. I trust my doctor to prescribe the right medicine because I know that every single medicine will have been through a trial and proven to work in certain circumstances; I know that he will not reintroduce leeches for me because of the system which states that leeches do not work. I therefore trust him because he is making a decision within a proven framework. Where is that framework for teachers? Where is the bank of evidence for what works? Where is the research for teachers to access and the time for them to do it? Where is that strand of professionalism whereby a professional person bases their practice on sound evidence and evaluates what they do? We have a lot more to do to give teachers the tools to do the job in the form of top-level information about what works.
	My second problem with merely devolving to and trusting teachers is that it is not the first time that a Government have tried to do it. The Tories tried when they were last in power and we tried with the academies. On both occasions, we ended up building a new middle. The Tories built the Funding Agency for Schools, having taken schools away from local authorities, and the Labour Government set up the biggest section of the Department for Education and Skills to manage academies having taken them out of local authority influence. History and evidence show us that-whether we like it or not-there is government, there are teachers and there needs to be something in between. There has been a lot of dissatisfaction, which I share, with local authorities performing that middle role. I do not argue about that: when they are good, they are good; when they are bad, they are awful. It is less than satisfactory.
	We have had three, very good middle layers which have been simply abolished or ceased to be funded. One was the School Sports Trust, which looked after sports in schools; another was Creative Partnerships, which looked after that section of the curriculum; and another was the whole specialist schools movement. They were the best middle layer that I had ever seen. They concentrated on training and top-level professional development; they made teachers researchers and reflective practitioners; they enabled them to create professional networks. I cannot see why a party of government who want to trust teachers have removed in one fell swoop a middle layer that was proven to work, that was not a quango, that spent money wisely and that had a track record of raising standards. Quite honestly, I could weep, because it is really bad education-time will tell whether it is good politics-and it will make it far more difficult for the Government to deliver on freedom to schools and teachers.

Baroness Walmsley: My Lords, I congratulate my noble friend Lady Perry on securing this valuable debate and my noble friend Lord Hill on turning up-it just shows that you can't keep a good man down. I agree with my noble friend Lady Perry that we must be ambitious for children. I agree also with the noble Baroness, Lady Morris of Yardley, about the importance of an evidence base. However, since I was a teacher, the internet has come along and teachers are lucky to have access to more information about what works and a greater opportunity to disseminate best practice than any generation of teachers that went before.
	An excellent education is what we seek for all children and for those who come back to education for a second chance, having failed for whatever reason the first time. I shall focus on getting the foundations right, because without good foundations the building will topple.
	Getting the foundations right falls into two categories. First, there is the task of getting to know the child and his/her particular needs as early as possible so that the right education can be provided. That means very early contact with trained professionals who can identify whether the child has any particular barrier, physical or mental, to their benefiting from normal education provision. If a barrier is identified, it is then important that suitable provision is made to help them get over it, without parents having to go into battle to obtain it. It may be physical mobility problems, sensory impairment, neurological problems, speech and language impairment, autism, dyslexia, learning difficulties, behaviour problems or emotional problems arising out of a chaotic home background. It may be impaired brain development, resulting from exposure to physical or emotional violence in the home. All these things get in the way of a child fulfilling their potential in the classroom.
	It is for this reason that I am delighted to welcome my Government's announcements about free early-years places for deprived two year-olds and the pupil premium. I welcome also their intention to provide diagnostic tests for all children soon after they start school. However, I urge my ministerial colleagues to bring the age down to two or three if possible and to ensure that the tests are carried out by fully trained professionals capable of diagnosing the wide range of conditions that exist. That is a tall order, but well worth achieving because of the enormous cost-benefit in the long run.
	There are considerable difficulties in providing enough professionals with the right skills. Many of us have spoken in the past about the problem of getting speech and language therapists. They often fall between two stools, working in schools but paid for by the PCTs. I hope that the forthcoming NHS reforms may help that situation.
	There is also the problem of educational psychologists on which several noble Lords have received a briefing from the Association of Educational Psychologists. It tells us that the Children's Workforce Development Council has frozen recruitment for EP training from 2011 onwards. Combined with the ageing profile of the profession, that could have a serious effect on the availability of these services to some of the most vulnerable children. Will my noble friend say whether the Government intend to look into this?
	The second area of getting the foundations right is learning to read and write. You cannot get an education unless you are literate. If you look at a young baby, the first way in which it communicates is not by writing something down: it listens. It listens to the voice of its mother and its father. It detects not just words, but the tone of voice, kindness, persuasion, anger and frustration. It knows immediately what mood its parent is in and often mirrors that in its response. Then it learns to vocalise and eventually to speak. Your Lordships may see what I am getting at. We must foster listening and speaking before we trouble children with reading and writing.
	Until a child can express a thought in words, it cannot be expected to turn that word into a squiggle on a page. That is why it is so important to address communication difficulties early. That is why I have always been sceptical about imposing phonics on all children at a particular age without reference to the teacher's professional judgment about whether the child is ready for that style of learning which, I admit, works well for many.
	There is a need for more children's radio than we have on offer at the moment and I took the opportunity of promoting that idea to Sir Michael Lyons when I met him last month. If you want a child to concentrate on language, pictures can be distracting. They have their place, especially in early reading books associating words with pictures, but if you want to encourage a child to listen you should sometimes ask him to concentrate on that.
	Stories and rhymes read aloud in programmes aimed correctly at different age groups lend themselves perfectly to the medium of radio. It grieves me that all we have now is a single catch-all programme on Radio 4 that does not succeed in serving any age group at all and is not listened to by many. I urge the BBC to pilot a new children's radio station. It could be very exciting, especially if it was as well researched as "Teletubbies". It could serve all children, but particularly the many thousands for whom English is not their first language and young children who are learning to listen and speak before they read.
	Finally, I mention the important issue of life skills and the well-being of the child, which makes him ready to learn. A child cannot learn if he is distressed, and many schools these days find themselves needing to take care of a child's emotional needs before they can help him to learn.

Lord De Mauley: I draw your Lordships' attention to the fact that this debate is time limited and Back-Benchers' contributions are limited to five minutes.

The Lord Bishop of Wakefield: My Lords, I also thank the noble Baroness, Lady Perry, for introducing this important debate. Earlier this month, I had the pleasure of officially opening the Trinity Academy in Halifax. Trinity Academy is in a deprived area of north Halifax and the diocese of Wakefield is the lead sponsor. The academy is a solution to the continuing, difficult and nationally publicised problems with the Ridings School. Presumably that was the sort of school to which the noble Baroness referred in her speech.
	The academy solution was worked out and worked for under the academy policy of the previous Government and we in the diocese of Wakefield are grateful to them for all that they did to make it possible. We are also very grateful to the ministerial team at the new Department of Education. I would particularly like to thank the noble Lord, Lord Hill, who helped us to proceed to academy status, and pay tribute to him for being with us today. I think we encountered each other earlier on his journey home, before he had that unnerving experience. I also thank the Department for Education for its commitment to funding the new building project there. New buildings are crucial for nurturing respect and self-esteem and will allow the academy to be fit for the purpose of providing a modern education. I am pleased to hear, therefore, that Her Majesty's Government are committed to 600 new building programmes.
	The bearing of Trinity Academy on this debate is that it will foster excellence within a poorer area of our diocese, which is indeed in an area of multiple deprivation. In his address at the opening, the principal spoke movingly, noting how teachers who spend time and energy in taking an interest in their pupils could change the life chances of their children. This had been the principal's own experience and was why he was committed to excellence in education. This is surely the key to the relationship between excellence and education; excellence can be nurtured and passed on to others by those who inspire and press students to strive for their best. Among other things, education is the handing over of the skills and tools for learning and the passing on of wisdom to raise up the next generation. Where we have fostered it, excellence will be seen to grow and spread into all areas of life.
	Investment in education can never be a waste, but it is always an investment in people, communities and whole areas. Trinity Academy is one example of the Church of England's historic commitment to schooling for entire communities in less well off areas. We still hold to that commitment. There are now 38 academies sponsored and at least part funded by the church in areas of deprivation. Of course, academies are not the only option, but it is our hope, in the context of the historic partnership of church and state, that Her Majesty's Government will continue in the same direction that they have pursued in developing Trinity Academy in Halifax. I can think of two other local schools where the same is true-the Sentamu Academy in Hull and the Church of England academy in Scunthorpe. We would like to see a continuance of academies opening in deprived areas and a focus on schools that do not yet excel. In the diocese of Wakefield, we are also pursuing other options for academies with co-sponsors in different LEAs and unitary authorities.
	We hope that the present focus on outstanding schools will broaden out more fully to encompass other schools. That would indicate a clear commitment to the fostering of excellence in all our communities and for all children and young people. As I opened the Trinity Academy, I returned to the earliest origins of the concept of the term. It was Plato who said:
	"By education I mean that training in excellence from youth upward which makes the young passionately desire to be perfect citizens, and teaches them ... justice".
	This is the only education that deserves the name.

Lord Ramsbotham: I congratulate the noble Baroness, Lady Perry, on obtaining this important debate and particularly on including the word "excellence" in its title. I firmly believe that the only raw material that every nation has in common is its people, and woe betide it if it does not do everything that it can to nurture and develop the talents of all its people. If it does not, it has only itself to blame if it fails. Ditto the wonderful words of Winston Churchill, when he said:
	"There is a treasure, if you can only find it, in the heart of every man".
	My concern that our education system is failing in this respect was confirmed by what I saw as Chief Inspector of Prisons: vast numbers of young people woefully below even level 1; 65 per cent of adult males with a reading age of less than eight; and truancy and exclusion figures among young offenders a national disgrace. Why is that and what can we do about it? In the time available, I can only scratch the surface of an answer. However, I have three experiences that I put forward for ministerial consideration.
	The first comprehensive school that I saw was a British Forces Education Service one in Germany in 1966, and it was achieving amazing results. When I asked the headmaster how he achieved this with pupils of all standards and ages, coming from schools all over the world at all times of the term, he replied, "very simple". The day was organised so that everyone did the same subject at the same time. On arrival, children were assessed in each subject and put into the class best suited to their ability. They could be in the top group in English and the bottom in maths. Talent or ability was the determinant, not age. When I said that if this was comprehensive education, I was all for it, he said that that was not how it was conducted in England, where pupils were moved up each year, regardless of ability, leading to those unable to keep up in one year slipping ever further behind as they moved up.
	My second point, which echoes what the noble Baroness, Lady Walmsley, said about communication skills is one that I have made on the Floor of this House many times. The scourge of the 21st century is that children cannot communicate with each other, their teachers, or anyone else. Assessment by speech and language therapists discloses a raft of reasons, some to do with learning disabilities or difficulties-all of which can be ameliorated-to enable the young person to engage with his or her teacher. I firmly believe-based on the evidence of what therapists funded by Lady Helen Hamlyn achieved in young offender institutions, prompting governors to say that they did not know how they managed without them-that every child should have their communication skills assessed before they begin primary school. In the light of so much evidence of the glaringly obvious, I despair that successive Governments have, so far, not implemented this, because unless children can engage with their teachers and therefore education itself, too many will remain uneducated.
	My final point reflects one made by the noble Baroness, Lady Perry, again about denied excellence. In 1999 Gabbitas initiated a programme called Tomorrow's Achievers, and I must declare an interest as a patron of the project. It provides master classes for that section of young people, namely the exceptionally bright, whose talents are currently ill served in too many instances. In each of the past two years more than 1,000 young people have been enabled to attend life-changing classes. Ten years ago they were offered to the then director-general of the Prison Service in the hope that they could rescue some who, often out of frustration, had turned to crime. So far, not one candidate has been put forward, and this remains yet another gift horse that I beg the Government to stable.
	My Lords, if you sense a mood of frustrated concern, you would be correct. I care for this nation, and above all for its future and the future of its citizens. Education is all about identifying, nurturing and developing talent, and if we do not do that excellently, we risk damaging its future-and we will be to blame.

Lord Baker of Dorking: My Lords, I declare interests as the chairman of Edge and chairman of the Baker Dearing Educational Trust, which are major educational charities, but of course I draw no remuneration from them.
	I very much welcome this debate initiated by my noble friend Lady Perry. She touched on a profound malaise in the English education system; that there are hundreds of thousands of 13 and 14 year-olds who are totally bored at school. They do not find that what they are learning has anything to do with the world of work. What do they do? Some bunk off; some turn up but are bored, frustrated and disobedient; and they drop out and hang around on the streets. There are hundreds of thousands of them; therefore, some four years ago, Ron Dearing and I decided that we should do something about it and, in particular, we should re-establish the technical schools. We had them in the 1950s-it was part of the 1944 settlement. They were abolished in the 1950s. English snobbery killed them; everyone wanted to be in the school on the hill and the technical schools were considered to be for dirty jobs and greasy rags.
	How did we set about changing this? We went to see the noble Lord, Lord Adonis; he supported us, as did the noble Lord, Lord Knight of Weymouth. These colleges-we called them university technical colleges-are different in three very important ways. First, they are for 14 to 18 year-olds. I have been quite convinced that the right age of transfer in the education system is 14, not 11. By 14, youngsters can largely make their own decisions. History is on my side; I commissioned some research-I believe in commissioning research only when I know what the outcome will be-from Exeter University to show why, since 1850, technical education in Britain has been so bad, whereas it has been very good in Germany, Sweden and America. One of the reasons is the age of transfer. In 1941, the Board of Education decided that the age of transfer should be 13 to 14. That decision was not reversed by Mr Butler or any Minister; the Permanent Secretary decided-such was then the power of Permanent Secretaries. He said it should be 11 because grammar schools started at 11. That was the decision. It was a huge mistake, and it was huge mistake to finish with technical schools. Germany has kept them. The German education system has a much lower rate of applications to universities than ours, but it has a much higher rate of technical training, technical schools and apprenticeships, which is one of the reasons why Germany is coming out of the recession faster than we are.
	Four years ago, we went to the Government and said that we want these schools to be different in three ways: first, they will be for 14 to 18 year-olds; secondly, a university and an FE college will sponsor each one to give it status; and thirdly, the curriculum of these schools will have two specialisms. Nearly all of those that are about to open have chosen engineering as one of the specialisms and then there are property services, IT and medical occupations-not doctors, but the people below doctors who, when you get my age, keep you alive when the doctor leaves the room. These colleges provide practical, hands-on training under the same roof as the academic work-GCSEs in English, maths, science and IT-because if you bring those two sides together under the same roof, you will have a significant improvement in literacy and numeracy. There is no doubt about that.
	These colleges are different also because we asked local employers, big and small, to shape the specialist curriculum, so Rolls-Royce wants three, British Aerospace wants one, Guest, Keen and Nettlefold wants one and local companies in Walsall want one. They are immensely popular, and I am glad to say there is traction in that the JCB Academy in Staffordshire, which specialises in engineering, opened this year and is oversubscribed as a start-up school. I hope that five colleges will open next year, provided that the Government give us money. We are not building lavish new schools at £25 million or £30 million a time; we go for empty buildings, refurbished buildings or closed schools. The FE world is now throwing up lots of empty buildings. We can take surplus buildings from the FE world, and one college wants to use an industrial building. We hope to open five colleges next year, and the Government have said that after that we can have 12.
	That is just a beginning because we are talking to more than 40 groups of people who want these colleges. They are important people from universities, FE colleges and leading businesses. I hope that we are going to have scores of these colleges in the lifetime of this Government because they are needed. They address the malaise that I talked about. They re-engage the interests of youngsters who want to turn up. These colleges will start at 8.30 in the morning with youngsters with tools in their hands, and they will do academic subjects in the afternoon. If they are late for 8.30, they are sent home. There is no question of them drifting in when they want. That is also one of the aspects of these colleges. There is huge enthusiasm for them, and I commend them to your Lordships.

Baroness Prashar: My Lords, I, too, thank the noble Baroness, Lady Perry, for initiating this debate and for introducing it in the way that she did. I am pleased to see that the Minister is able to be with us despite the mishap. I look forward to his response because I had the pleasure of working with him when I was part of the National Literacy Trust.
	There are hundreds of primary schools where the majority of children fail to get to an acceptable level in English and maths. These children leave primary schools without the knowledge and skills required to follow the secondary school curriculum and make a success of the rest of their time in education. Many of these children do not reach an acceptable level of literacy by the end of their time at primary school and their time at secondary level is often wasted. About one in five children leaving primary school does not get to level 4 in English.
	The gap in attainment between the rich and the poor is shameful. For disadvantaged pupils, a gap opens even before primary school. Research shows that the highest early achievers from deprived backgrounds are overtaken by lower achieving children from advantaged backgrounds by the age of five. In 2008, National Literacy Trust research showed substantial differences in life chances, quality of life and civic and cultural participation between those with low literacy levels and those with higher levels of literacy competence. So, the direct link to social mobility and low aspirations is all too evident.
	The Government's move to make schools more autonomous by giving professionals greater autonomy, and to make the funding system fairer by providing extra money for young people from deprived backgrounds in order to ensure that children struggling with the basics get the extra help they need, is truly welcome. However, we know that there are other areas of school life that will not be covered by the pupil premium.
	One of these areas is school library provision. Good school libraries contribute to excellent literacy outcomes for the schools in which they are based, but not all schools have a library. The number of schools with libraries has been falling in recent years. Research shows that only about 58 per cent of secondary schools have a library run by a professional librarian, and that libraries are often not fulfilling their potential.
	In a difficult economic climate it is the support services such as these that run the risk of being reduced. Cuts will inevitably impact upon the poorest schools and those most disadvantaged. It is therefore important that we do not neglect the support services, such as school libraries, in the most deprived areas.
	We all know that children's life chances are strongly affected by their parents' circumstances. Researchers at the National Research and Development Centre for Adult Literacy and Numeracy found that parents' literacy level is a key indicator of their child's literacy. That was backed by the Sutton Trust research this year that found that children's exam results in England were more strongly linked to their parents' education than in many other countries.
	Against that background of high intergenerational transfer of poor skills, support also needs to be focused outside the school. Parents are a child's first educators, and it is in all our interests to ensure that they have the necessary encouragement, support, confidence and knowledge to perform this crucial role. Families provide the foundations for early literacy development among very young children. Language-that is, speaking, listening, comprehension and vocabulary-is learnt through interaction with adults. Parents do this through conversation and encouraging imaginative play, and by reading stories. It is the parents who have the greatest role to play in helping their child to develop as a skilful communicator and a competent learner.
	All parents wish to do their best for their children but often lack confidence or knowledge. Parents therefore need to be empowered to recognise the contribution that they can make and to be helped to make that contribution. Language is the key to learning. It is therefore important to increase awareness of the importance of these skills among parents if we are to ensure excellent education for all pupils and young people. If we want to tackle disadvantage and ensure excellent education for all, we need to develop professional practice, underpinned by appropriate professional development, that values the contribution of home and community literacy activity and knows how to make it work.
	We need to have a clear responsibility for the development of a home and community literacy strategy and build on the work done by organisations such as the National Literacy Trust and others. We need greater incentives to encourage partnership working between schools, parents, community groups, and voluntary organisations, and we need to support and help all those working to create an environment and the social conditions in which learning can flourish and foster children's language development. Is this not what the notion of a big society is about?
	Bearing in mind how important literacy support outside schools is to the future of excellent education in this country, what steps are being taken to ensure that the Government, local authorities and schools are giving priority to family and community literacy and learning?

The Lord Bishop of London: My Lords, I join other noble Lords in thanking the noble Baroness, Lady Perry, for introducing this significant debate. The content of the phrase "excellence in education" obviously depends on our view of human beings and our understanding of what constitutes fulfilment in life. If we are simply fodder for the economy, or consumers who have to be equipped with critical tools to make choices, then we shall look for excellence in number-based subjects. If, on the other hand, without despising our role in the economy, we regard the overarching story of a human life as claiming freedom from dependence, becoming independent and then being equipped for interdependence in those mutual relationships that for most people bring joy and meaning to life, then our understanding of "excellence" will be wider.
	I declare an interest as president of the London Diocesan Board, which has the privilege, every day, of educating 50,000 young people in London north of the Thames. Many of our schools are hundreds of years old. I echo my right reverend brother in saying that they were established to serve the whole community and not just the Anglican part of it. We reject the category "faith school" because it is misleading about the motivation and operation of our educational work. I have often wondered what is supposed to be the opposite of a faith school; perhaps it is a "doubt school". Every school is informed by an educational philosophy and assumptions about human life. It is simply that our schools' philosophy is clearly stated and not concealed.
	It seems to me that every child has a right not to be under pressure at school to convert to any particular philosophical or faith position, but every child has a right to be equipped for a good life with three things: religious literacy, ethical clarity and spiritual awareness, which is often best developed by music and the arts. Our schools serve a diverse constituency. I asked one of the imams in Tower Hamlets why he sent his child to the church school. His reply was simple: "God is honoured in our church school".
	My daughter recently did her GCSEs at the Grey Coat Hospital, an 18th-century foundation close to your Lordships' House. Out of just over 1,000, 664 pupils are from ethnic minorities. The deprivation indices are high but the contextual value-added result is 1,021-one of the best scores in the country. As your Lordships will know, the UK average is 1,005.
	Excellence is not to be confused with elitism and we have also been grateful for the initiatives of the previous Government, and the present one, aimed at increasing access to excellence for all. We have opened four new academies in the diocese, and the fifth has the theme of science and religion. The noble Lord, Lord Winston, and I will be playing second and third fiddles respectively to the Secretary of State when it is opened towards the end of November. The proposed St Luke's School is in the first wave of the new free schools.
	I am aware of the helpful conversations which have been going on at a national level between the department, the Church of England, the Roman Catholic Church and those responsible for education in the Jewish community to achieve a consistent designation of any new schools with a faith-based character, so that their proper freedom is secured while the possibility of supportive relationships with wider groupings is preserved. The vision of the big society, as the noble Baroness pointed out, recognises the contribution of those intermediate bodies, the little platoons that occupy the ground between the state and individual units. It would be wasteful to neglect the additional resources available through church, mosque, temple and synagogue-based educational charities.

Lord Brooke of Sutton Mandeville: My Lords, it is as much a privilege as a pleasure to follow the right reverend Prelate the Bishop of London, whose leadership within his great diocese is, appositely to this debate, a lesson for us all. I offer a warm word of thanks to my noble friend Lady Perry. We first met within the old DES under the late, great Sir Keith Joseph, later Lord Joseph. She has always been a champion-nay, a heroine-on the issues underlying this debate. So she has been today.
	The virtue of a debate of short speeches is to concentrate the mind. I have only one subject to raise with my noble friend the Minister: the supply of male teachers in primary schools. I had a great friend from Oxford who won the top history scholarship of his year, then got a first. He played cricket, hockey and squash for the college, secured a short-service commission as a captain in the Royal Army Education Corps and spent the rest of his career as a teacher in primary schools-not even, to the best of my knowledge, becoming a head teacher. Finally, in retirement-or possibly earlier-he was a schools examination marker at a much higher level. We shared many interests, sometimes of an old fogeyish kind, and we corresponded regularly until his sad death early last year. He was much preoccupied with the subject I am raising.
	I yield to no one in my admiration for the noble Lord, Lord Adonis, who was an outstanding Minister for both education and transport. He was so in charge of all his briefs that he almost invited supplementary oral questions by making his answers so precise, comprehensive and short that there was always time for more questions. Not all Ministers have that polymath confidence and fluency. When I asked the noble Lord, Lord Adonis, an Oral Question about the state of play on my subject today, he was more reassuring than I expected. Perhaps the numbers were simply, if modestly, moving in the right direction. The fact remains that in 2009-10 male teachers made up just 12 per cent of registered primary school teachers and 28 per cent of primary schools in England had no registered male teachers at all.
	Why do I worry about it? My noble friend Lord Baker of Dorking and I are of the same age, give or take three months. We therefore entered the primary stage at around the same time and during the war. He has always been a constructive martinet on grammar, spelling and punctuation. I share that enthusiasm. We jointly suppose it is because, during the war, the absence of so many at the war meant that we were taught by teachers of an earlier generation, who may well have themselves been educated in the Victorian and Edwardian eras.
	I do not know where my noble friend Lord Baker was at school in the war, although I believe it was in the north-west. I was at a rural preparatory school in Buckinghamshire where, even during the war, the majority of the staff were still male. I pay tribute to the excellence of the teaching we received. I do not want to make too much of this but the same male majority was true of the prep schools attended by my three sons on the Isle of Purbeck, 30 or more years ago. Their great school rival was the similar school down the road, attended by the late, great Michael Foot. I do wonder, however, if there is not a monograph to be written on the scale of the effect of this male majority of teachers at that age on the comparative overall performance of the independent sector.
	I raise one other consideration. During the 1998 defence review under the previous Government, when I was still in the other place, my own defence of the two TA units in my inner city constituency included in my armoury the fact that 43 per cent of their cadet force recruits were from ethnic minorities and 53 per cent were from single-parent families. There is no doubt that a male-oriented environment in those TA units went some way to providing structure in what were sometimes fairly broken lives. Both my TA units survived the cull.
	I end with a debt of honour to one of my own teachers from the war, not least because at 93 he is still alive and can read it. When we look back on those who had formative effects on us up to the age of 25 but outside our own families-I reiterate the significance of this in depleted families-they are sometimes clergy, sometimes sports coaches, sometimes contemporary friends but predominantly from the ranks of our teachers. Freddie Madden was a history postgraduate student at Christ Church College, Oxford, when war broke out. He could not serve because of health problems. He was planning an academic career, which he resumed at Oxford in the winter of 1946-47. He deliberately declined to teach history so that he would not gain any academic advantage over his contemporaries who were away fighting. He taught English grammar and literature brilliantly, and beyond that introduced us to a wider culture. This is at the margins of the issue I am raising because of the special wartime circumstances, but the impact of his teaching was not and is not.

Lord Parekh: My Lords, I begin by thanking the noble Baroness, Lady Perry, for securing this debate and introducing it with the clarity that we have come to expect of her. I may not agree with everything she said but she presented some extremely interesting views on what we ought to be doing.
	I think we all agree that we have one of the most unequal systems of education in the world. Our best schools are better than any that one can think of in other parts of the world but a large number are struggling. We have a tradition of catering to the elite, encouraging excellence among them, but not paying as much attention to excellence so far as the rest of the population is concerned. Consider some of the results. Many of our schools produce rather poor results at primary and secondary levels. There is profound alienation from the education system, leading to around 300,000 suspensions in any given school year. There are 250,000 persistent truants and thousands of teachers are abused and attacked every day. This all leads to an enormous waste of talent but that is not the only important thing. It also means that we are unable to compete with such countries as Singapore, South Korea or Germany, where the education systems tend to cater to a large body of people in a meaningful way.
	It is also striking how poverty and disadvantage impact on our education system. There are 80,000 pupils who are eligible for free school meals every school year. They are the poorest achievers. They start performing badly in primary school and that continues from one stage of school to another, right up to university if they ever manage to get there. In this context I am particularly worried about some of our ethnic minority pupils. I am here thinking about Pakistanis and Afro-Caribbeans, who tend to achieve rather poorly. If we are to tackle this, we ought to think about providing extra funds for schools and areas where underachievement is rampant. It is a question not only of concentrating on schools and pupils but of attending to the larger question of economic and social disadvantage.
	If we are going to attend to a large body of our schools where underachievement is a problem, we ought also to think of attracting high quality teachers. As has already been said, teaching staff these days are much better than they used to be, thanks to many of the efforts of the previous Government. Nevertheless, compared to what happens in Finland, Sweden and many other countries, we still have a long way to go. We must find ways not only of attracting highly qualified graduates but of providing better teacher training with a strong practical orientation. Here, again, I alert noble Lords to the virtual absence of ethnic minority teachers in many parts of our country. In all, 94 per cent of teachers come from the white community. In the north-east and south-west the figure goes up to 99.2 per cent. Ethnic minority teachers are important, partly because they provide inspiring role models for ethnic minority pupils, but also because they get white students used to the diversity of our multi-ethnic society.
	Another point has to do with the obsession over the past few years with grading and exams. We ought to concentrate on the learning experience, on fostering the capacity, as the right reverend Prelate the Bishop of London said, for analysis, imagination and interdependence and encouraging intellectual curiosity. That will require a fairly drastic reorientation in how our curriculum is structured and taught. I particularly emphasise a certain degree of parochialism in our education system. There is not as much openness to other civilisations and their achievements, or to other languages, as there ought to be. This partly explains why modern languages are largely neglected or marginalised in many of our schools. A language is a window to another civilisation. Unless one is interested in other civilisations there is no reason why one should be interested in those languages, except in functional terms, which is hardly the way to learn a language.
	It is also important to bear in mind that much of our education tends, certainly at the school level, to be rather narrowly based. If you compare our A-levels to the international baccalaureate, you begin to see why it is important that we should encourage students to take a wider range of subjects. We ought to do something similar at an earlier stage and make sure that English, mathematics and science are not the only subjects that are required to be taken until the age of 14. Once we begin to do that, we will begin to provide a broader base and a more literate and civilised society.

Baroness Sharp of Guildford: My Lords, I, too, pay tribute to my noble friend Lady Perry for initiating the debate and for her very thoughtful and incisive introduction of it. I have spoken frequently in this House of my experience as a governor of a primary school in Guildford that serves a disadvantaged community there and of my experience as a member of the board of the corporation of Guildford College, but I do not think that I have ever spoken in this House of my experience over the past 10 years as a member of the local council -that is roughly equivalent to being a governor-of Guildford High School for Girls, one of the highest achieving independent girls' day schools in this country. If one looks for an example of excellence in education, such a school provides it. It not only achieves extremely good results in academic terms but provides an all rounded education in music, the arts and extra-curricular activities ranging from working with Crisis at Christmas in London to canoeing in the French Alps. All told, it seems to me to prepare these young women not only to achieve good academic results but to be good citizens and to be able to enjoy life to the full.
	When I read the title of this debate-excellence in education-I reflected on what contributes to that and how far that can be translated into the public sector. First, there is the whole question of parental background and parental advantage. The girls who attend Guildford High School come from extremely advantaged homes. Their parents talk to them when they are little and read to them. We know all this and we also know that, by the age of 18 months, the learning of children from very advantaged homes is three months more advanced than that of children from disadvantaged homes. Therefore, all the comments that various noble Lords, including my noble friend Lady Walmsley, have made about getting the foundations right are so true. We have to concentrate on the early years and put money into them because they are absolutely crucial. I do not want to say any more about that other than to reiterate the point made by the noble Baroness, Lady Prashar, on the importance of these children being able to read and write by the age of 11, and, therefore, the importance of one-to-one tuition and the Every Child a Reader programme in ensuring that they are helped if they are lagging behind.
	My second point concerns money. The fees for most of the top-achieving private schools equate each term with roughly what we spend per pupil in secondary schools-£4,500. I do not think there is any way in which the public sector can ever emulate that. The pupil premium of £2,500 per child-it will vary a little-goes nowhere towards compensating for this. What does it buy? It buys smaller classes and individual tuition, all of which is important. However, we need to think about three things here. The first is the quality of the teachers. Finland provides a good example in that regard as the aim there is to recruit top-quality people into teaching. I am absolutely delighted that teaching has now become a profession of choice for some of our top graduates and I pay tribute to Teach First, which has helped to achieve that. The second thing we need to think about is the training of teachers and continuous professional development, both of which are vital if the quality of our teachers is to be maintained. Today's generation of teachers are excellent, but it is vital that their quality is maintained.
	The third thing we need to think about are extra-curricular activities. It is important that state schools try to provide the range of activities that one sees at some private schools. The best of them do and I pay tribute to what they achieve. There is pressure on teachers and, given the hours that they have to teach, devoting time after school to extra-curricular activities is often difficult. However, these activities provide young people with all the attributes which the CBI is looking for, such as the ability to communicate and to work as part of a team with all kinds of different people. Therefore, sufficient money should be allocated to enable extra-curricular activities to be provided.
	In conclusion, I do not think that we can ever compensate for home background but I am not sure that we ought to try the kibbutz experience of taking very young children away from home. Such attempts have not succeeded and the young children involved became very aggressive, difficult and mixed-up young people. It seems to me that we need to think about four things: first, the quality of teachers; secondly, giving those teachers the room to practise their professionalism, as the noble Baroness, Lady Perry, said; thirdly, the importance of the early years experience; and, fourthly, the importance of extra-curricular activities.

The Earl of Listowel: My Lords, I, too, thank the noble Baroness, Lady Perry of Southwark, for initiating this important debate and express my admiration to the Minister for his resilience after his awful experience of yesterday.
	I begin by highlighting the outstanding achievement of the previous Government in improving excellence in education for all children, particularly for children in care. Ten years ago, Professor Jackson highlighted the failures in the education of looked-after children. Only 1 per cent of children in care went to university. The latest figure we have for that category is 8 per cent. That figure is far lower than we would wish but it is still far better than that of 10 years ago, so I pay tribute to the previous Government for achieving that.
	I also take this opportunity to pay tribute to the wok of Tim Loughton, the Minister for Children and Families. We all know that the most important factor in successful education is what happens in the home, not in the school. That is the biggest factor. Children need stability and someone in the home who cares about them, sticks with them, is interested in their welfare and has high aspirations for them. Children in care need a foster carer who can do that for them. Foster carers can do that only if they have the support of a good social worker. Mr Loughton has supported the work begun by the previous Government in setting up the College of Social Work and has introduced a review to look at how we can reduce the bureaucratic burden on social workers. Recently, he spent a week shadowing social workers in Stockport to see exactly what they do in their department. He is admired by many of those working in the field. I highlight the importance of that work in terms of achieving excellence in education for looked-after children in the future.
	The noble Baroness, Lady Sharp, the noble Lord, Lord Parekh, and others have talked about the importance of having excellent teachers and about the need to recruit and retain them. I wish to concentrate on two aspects. The first is the importance of consultation with head teachers and the whole school staff to help them bear the emotional burden of the work that they undertake. The second is the importance of paired reading, particularly for vulnerable children. As regards consultation, I draw the Minister's attention to the work of the Place2Be charity and of Emil Jackson, a child and adolescent psychotherapist practising at the Brent Centre for Young People, who for several years has provided consultation to the staff groups of 10 schools in Brent. I will talk about his work in more detail later, but the Minister might like to read the paper, "The Development of Work Discussion Groups in Educational Settings", published in the Journal of Child Psychotherapy in 2008. This week the British Association for Adoption and Fostering launched its Supporting Children's Learning training programme for foster carers. This is a 10-day programme to train foster carers better to help children in their care with literacy. Will the Minister kindly draw the attention of Mr Loughton and of Mr Gove, the Secretary of State, to this programme?
	Teachers face challenges in school. I will be brief. Just as the Minister has demonstrated resilience, so teachers-as the noble Lord, Lord Parekh, highlighted-have to show resilience in the face sometimes of violence and sometimes of children self-harming or suffering depression. According to the Office for National Statistics, in 2004, 10 per cent of children between five and 15 had a mental disorder. Very often, teachers leaving the profession say that they have had an issue with a particular child and found that senior management did not support them in dealing with it. So many of our teachers burn out. If they stay in the profession, they simply lose motivation, because they are not assisted in dealing with the emotional burden of their work.
	I commend the work of Emil Jackson and the Place2Be in this area. In evaluating his work, 97 per cent of teachers said that the support had enabled them to persevere with children on whom they would otherwise have given up. How expensive is it to train a teacher? How expensive is it to get a good head teacher? How valuable is the experience that they accrue over their career? Surely it makes sense to spend in the region of £9,000 a year for a half-day consultation per week, in order to enable teachers to continue to work, in particular with the most vulnerable children. I look forward to the Minister's response.

Lord Blackwell: My Lords, I thank my noble friend Lady Perry for opening this debate, and the Minister for being here. Like others in this House, I am passionate about excellence in education. However, despite many good things in our schools, I am sometimes sad and frustrated at the way this generation has let down those who sought to follow in our footsteps, by waging a misguided and socially divisive war against that great engine of social mobility, selective education based on merit.
	We talk about excellence. Of course, excellence for all is fundamental. Like others, I support the Government's programme of returning power to teachers and parents, and opening up choice and competition through academies and free schools. However, we must talk also about excellence for the most able. All children are born equal, but, as my noble friend Lady Perry pointed out, they are not all born equal in ability or aptitude. We recognise that freely in sports, music and dance. We provide tailored training and support to create Olympic champions. However, somehow we deny, or are embarrassed by, the same logic applied to academic ability. Over the past 40 years, we have destroyed many excellent grammar schools and made selection a dirty word, yet there are many reasons and much evidence to make us believe that selective schooling, which allows the brightest kids from across social backgrounds to learn and develop together, has created huge benefits.
	There are educational benefits. Stimulated by their peers, bright children can do much better. They can be stretched by high expectations in an environment with others who also want to learn. However, perhaps more important are the social benefits of bringing together children from different social backgrounds and raising the aspirations and confidence of those from less privileged backgrounds as they mix with others from more privileged backgrounds. I will share one fact. We often refer to the measure of value added. In 2005, grammar schools accounted for the vast majority-86 out of 100-of the top schools in the country when success at improving performance between 11 and 14 was measured. They are not just taking in bright kids and processing them; they are adding huge value by helping kids from all backgrounds to perform better.
	It is a scandal that inequalities have widened and social mobility has declined over the past 40 years as a result of taking away the ladder of opportunity. Fewer people from state schools, as opposed to independent schools, are getting into the top universities and professions. Of the top 500 schools ranked on GCSE and A-level results, only 150 are non-fee paying. Of those 150, 127 are selective. Do we really believe that children from families who can afford to pay for private education are inherently brighter than those from middle-class and working-class backgrounds whose parents have to rely on the state system? The answer must be no. We are systematically failing the brightest kids from poorer backgrounds by denying them the ladders that would get them into the best universities and professions.
	What do we do about this? The response should not be to tear down the excellent schools in a fit of jealousy, or to force top universities to lower their standards in order to engineer social outcomes. Instead, we should reverse the antipathy towards selection that we have had for too long, and recognise it as the friend and not the enemy of a more equal and meritocratic society, where what you achieve reflects your ability and aptitude rather than the wealth of your parents. I make it clear that I am not advocating a wholesale return to a compulsory 11-plus. I would like to see free state schools, including academically stretching schools, open to all children based on their ability and aptitude, if their parents wish to apply. Those schools should take from the widest practicable catchment area, so that they give all kids in the area the chance to participate and have the opportunities regardless of where they live.
	I will pick up on some points made by my noble friend Lord Baker. School entry should not be fixed at any one age. Schools should take children at different ages, recognising different development rates. Most importantly, they should take children from all social backgrounds. How they select them, I leave up to them. The most critical thing is that the selection criteria should be based on the potential for high achievement, not on current exam results. Our aspiration should be to have the highest quality education available to those with the highest ability and aptitude, regardless of their social background. These schools should be a destination of choice for bright children regardless of their parental background-as grammar schools were, and in many places still are. Only when we have schools that are destinations of choice for everyone will the brightest children all come together to learn and create the social mix that is so important to the future leadership of the country. We must stop our antipathy towards selection and recognise that it has a much greater place than we have recognised in a fair and equal society.

Lord Bew: My Lords, I, too, thank the noble Baroness, Lady Perry, for securing this debate. I have been in this House long enough to understand the great passion, sincerity and knowledge that she brings to this topic, which she showed in her opening speech today. I also thank the Minister for coming to the debate under difficult circumstances.
	Already today the noble Lord, Lord Parekh, has raised the issue of the marginalisation of language teaching in our schools. This must be part of the theme of excellence. I will talk for a minute about Germany. The noble Lord, Lord Baker, mentioned the German example from one angle. From another angle, one of the most striking things is the decline in the teaching of German in our schools, and also the way in which we are now disproportionately dependent for our modern language teaching on private schools. These two themes are very worrying. Many noble Lords rightly believe that China is the workshop of the world and that Japan is an extraordinarily important country. We will always have difficulty finding enough good teachers in this area. On the other hand, the teaching of German, for example, should be a relatively easy problem to correct. I take some comfort from the fact that the coalition Government seem to accept that this is a special difficulty which they will address-I refer to the speech of the Secretary of State in September.
	I turn to a more complicated problem of the statistics on which we base our discussions of education. We have received for this debate an excellent briefing pack that contains many statistics and comments on our own performance, and comparative references to other countries. I accept the tremendous value of this. We have to take into account that it appears that in a number of crucial league tables, we are slipping down. I am absolutely certain that it is right that the coalition Government take this seriously.
	However, as anyone involved in education knows, it is very difficult to assess correctly the value of statistics either across time or between different countries. Exactly how much are we really comparing like with like? We all now believe that the Finnish system is marvellous-perhaps the best in the world. However, if one stops and thinks, one realises that the world is more frequently rocked by, for example, Israeli ingenuity than Finnish ingenuity. We all shudder at the statistic that 57 per cent of French pupils are required to learn certain years by rote. We all think, "Thank heavens. At least we haven't got that wrong. We don't do that". Then again, if the French system is so bad, why is there so much evidence of tremendous French cultural, intellectual and scientific vitality? Therefore, one needs to be cautious about these statistics.
	However, there is one statistic that cannot be challenged, and it brings home to us the great difficulties that we now face in our educational policy. I refer to Northern Ireland's performance in A-level results compared with those of the rest of the United Kingdom. Northern Ireland has not changed its educational system in the way that the rest of the UK has done over the past generation and a half and, again this year, Regional Trends, volume 40, confirms that A-level results in Northern Ireland are much better. For a long time people could say that at the bottom level Northern Ireland did less well than England, but the results at that level are now roughly the same.
	That is an important statistic but there is something even more important to remember, and it is often forgotten. I refer to the perfect control experiment in the social sciences. When I was a schoolboy in Belfast in the 1960s, Northern Ireland was behind the rest of the United Kingdom in its results, and that provided a perfect control experiment. From the figures, one knows that something has gone wrong in the rest of the United Kingdom-there can be no argument with that statistic. This, I think, is the difficulty that we now face in our educational thinking. The academies project is the only and best way of facing up to that difficulty because, if it works as planned, it will, I hope, increase the number of schools with an esprit de corps. One feature of Northern Ireland is the large number of schools with an esprit de corps, and this seems to be the one way forward. As many noble Lords have said, we are very fortunate that this generation of teachers is the best qualified that we have ever had, because that is what we need.

The Viscount Younger of Leckie: My Lords, this House and the country have been absorbed recently by the CSR, which has highlighted the steps that the Government will take to resolve the deficit so that our children and grandchildren are not burdened by the miscalculations made during our lifetime. Equally, it is vital that, for the benefit of our successors, we establish for the long term a culture of excellence, progression and consistency in education.
	I thank my noble friend Lady Perry for the opportunity to contribute to this timely debate. First, in touching on the CSR, it is comforting to note that the budget for schools will be increasing in real terms over the next four years, together with the introduction of the pupil premium, reflecting the importance that the Government place on education for those of all abilities.
	Young people must be able to gain the necessary qualifications that lead to gaining skills and business acumen in order to compete in the global marketplace and sell our goods and services abroad to the markets of the future, from which we must grow our own economy. However, to echo the words of my noble friend Lady Sharp, the provision of excellence in education can be realised only if the teaching profession is able to attract, retain and develop the best graduates.
	It is well known that there remains too strong a link between wealth, or the ability to pay privately for education, and the best results at school. My right honourable friend the Secretary of State for Education has laid the foundation stone for reform by moving to free up schools from bureaucracy, health and safety restrictions and overinterference from local authorities, returning to headmasters the right to decide how to manage their schools and their budgets. In addition to initiating and defining their own strategies to suit their specific needs, schools outside the independent sector now have a stronger story to tell and a better platform from which to recruit the best teachers.
	The OECD has shown that autonomy in schools helps to improve standards. In 2002, McKinsey undertook a comprehensive study, one of the conclusions drawn being that the best performing nations have the best quality teachers. I believe that we are moving in the right direction by providing a more attractive environment for teachers so that they can, unfettered, use their energy, personality and creativity mixed with their subject skills to enthuse and motivate their pupils.
	For teachers to thrive, there must be some flexibility in the school curriculum and ethos so that they can develop their own teaching methods and instil interest, and consequently improve discipline in the classroom. The disruption figures are somewhat daunting to read. As the noble Lord, Lord Parekh, highlighted, each year there are more than 300,000 suspensions and a quarter of a million persistent truants. Is it therefore surprising that sickness absenteeism among teachers is high? In the past eight years, at least 55 per cent of teachers per year in the local authority maintained sector took sickness leave. On average, each teacher was off work for nine days each year.
	The process of recruiting teachers starts with the basics-first, with the schools and the question of how to reach out to teachers, not just parents, by marketing the school and presenting it in the right light to prospective teachers. It helps if there is a glossy brochure. A job specification needs to be detailed, accurate and challenging. The role, while likely to be subject-specific, should also include details of its objectives and scope, and there should be flexibility for personal teaching methods. The job must allow for measuring the success of the teacher against clear objectives. Under this Government, head teachers will be able to offer more flexible terms and conditions, and will be able to set a pay rate to balance what their school can afford with teacher aspirations.
	In terms of methods of recruitment, schools should join and develop teacher networks nationwide so that they are aware when sought-after teachers might be ready for a career move and can follow up with alacrity when they are. In recent years, executive search organisations have entered the educational sector with considerable vigour and success.
	The inevitable loss of jobs in the public sector will provide an opportunity for some people to seek retraining for teaching. The new academies have already tapped into this source. Innovative teacher training organisations, such as Teach First, have a vital role to play. Graduates in TF are primarily earmarked for the most challenging schools, and it is projected that by 2018 100 of the top cadre of 3,000 will be head teachers. The Teach First values perhaps sum up what we should aim for in all teachers: collaboration, commitment, excellence, integrity and leadership.
	A further challenge is to recruit teachers who are contractually bound to take responsibility for extra-curricula activities. Notwithstanding that we have seen a regrettable reduction in playing field acreage over the past 13 years, it is essential for the health and well-being of pupils that they take part in competitive sports and learn what it is like to win and lose. Furthermore, it is essential that they are educated outside the classroom, from geography field courses to debating in-house-perhaps producing aspiring future Members of this House.
	The inclusion of so-called life skills is, I believe, another essential ingredient in seeking to achieve excellence in education. I find it surprising that it is not mandatory for all school leavers to learn and understand the practicalities of managing home accounts or to be aware of how a mortgage operates or how a car works.
	In conclusion, teachers are a key ingredient for excellence. We must aspire to emulate other countries-notably Finland, where teachers are recruited from the top 10 per cent of graduates.

Lord Knight of Weymouth: My Lords, I refer to my entry in the register of interests in respect of my consultancy work in education. I congratulate the noble Baroness, Lady Perry, on instigating what has been-my comments aside-a very fine debate, showing off the House at its best. I very much look forward to the Minister, the noble Lord, Lord Hill, winding up in his usual skilful way.
	I think that there is a danger in looking to the past when we look to fixing the problems of the present going into the future. I was certainly mindful of that when listening to the noble Lord, Lord Blackwell. However, I want to dwell a little on the past and express my pride in our record in office over the past 13 years. I am grateful for some of the comments that noble Lords have made regarding aspects such as Teach First. We increased by 50 per cent in real terms the amount of revenue funding. As a result, many more teachers-30,000 or 40,000-were employed, together with about 120,000 more teaching assistants. Many noble Lords have said that we have the best generation of teachers that we have ever had, so it should be no surprise that results have improved. They were also operating in much improved buildings. We fixed the roof while the sun was shining. We have seen, for example, the results for five A* to C grade GCSEs, including English and maths, go from 38 per cent in 1997 to more than 50 per cent now. We saw a fantastic investment in early years teaching and we are yet to be able to judge how that will benefit the country and benefit social mobility, to which I shall turn in a moment. We also saw a rapid expansion of the numbers qualifying to go into higher education, as they certainly have done.
	On the basis on which our school system was set up, we drove it hard and we achieved good results, but the system was not designed to tackle social mobility. On that we did not do well enough. Although many children from poorer backgrounds did much better, thanks to the extra investment and the work of the teaching workforce, it is important to note that the gap between free-school-meal pupils and non-free-school-meal pupils narrowed only marginally, apart from those with special educational needs.
	It is worth saying that at school level and local authority level, the gap narrowed. If we were listening to the Secretary of State, who I think is asking the right question about social mobility, the answer would not be about school-level reform. I am very proud of the academies which we set up, and for which I was responsible during my time in office, but the analysis done academically shows that they are making a difference at the margins. In essence, if we are to foster the talents of our children, and of every child, as this excellent Motion says that we should, we need a 21st-century system which properly reflects the needs of the labour market and properly engages every single child in their education.
	I do not think that we should try to reinvent a free market school system, as that has been tried in Chile, the United States and Sweden and there is no evidence whatever that it works. I shall not dwell on the questions in today's Guardian about how the free school network, which is trying to promote that free market system, was funded and why it was selected. If the Minister wants to answer that question, I am sure that the nation will be grateful.
	If we are to design a school system that is to tackle social mobility, we have to focus on what goes on in the classroom and in the home. We have had some excellent contributions. The statistics from the noble Baroness, Lady Prashar, for example, were notable and showed that a lot of the difference is defined before children get into school, so expecting us in our school system to fix those problems is, in many ways, missing the point. I refer noble Lords to the excellent report from the Equality and Human Rights Commission of a few weeks ago which showed that the highest performing ethnic group in our country is Chinese girls and the second highest is Chinese girls on free school meals. They overcome poverty because of the culture and motivation at home.
	We need new forms of home engagement and new forms of accountability which will incentivise different forms of teaching in our classrooms, and encourage more-what better place to propose it?-peer-to-peer working in our classrooms, and more partnership between pupils and between pupils and teachers using technology to the full. Then I think we can get the sort of collaboration, teamwork, leadership and confidence to present that our employers say we need, and the teaching will then reflect that, whereas at the moment collaboration in school is regarded as copying-and that is cheating.

Lord Addington: My Lords, in speaking in this debate, I feel as though I am carrying on from our debate last week on special educational needs. I shall address other factors which I did not have the time to address then. Listening to the contributions in the debate, it has become apparent that there is a degree of consensus in the House. I can safely say that things are better than they were, although they are not perfect and not everyone has all the right answers at any one time.
	In talking about excellence, it is easy to hide behind its definition. According to most of the statistics which I picked up from the Library in the usual good briefing pack, it is all about achieving a GCSE in English. I may have taken part in a debate on education when I did not mention dyslexia, but I cannot remember when it was. Considering whether you have achieved excellence or access to the system seems to depend on whether someone has passed English GCSE, but 10 per cent of the population has a condition which means that they have difficulty in processing language. Immediately, you have a problem, which will be obvious to everyone in the House. The question is: how do we deal with it?
	Greater awareness of the problem has, undoubtedly, permeated through the system and greater knowledge is behind that. Last time, I spoke about the fact that the British Dyslexia Association thinks that it can train people in about half a day to spot-not to deal with-someone with dyslexia and to pass on information to the pupil and to the parents. I made a joke, which I shall not repeat, about the fact that if you get the parents on side when there is a problem in the school system, you can generally get something done. It may not be the right thing or may not be done quickly enough but something will happen. You will have problems unless you can get the information into the system, as many other people have said, and unless you can include the parents. Often, you will also need to identify parents who are dyslexic.
	That ties in to many other things which have been said in the debate. My noble friend and the noble Lord, Lord Ramsbotham, both mentioned speech and language. Most of the ways in which you cope with dyslexia are with the use of speech and language. There is then the problem of what happens if a pupil comes from a household which is chaotic and which does not have resources, where developing the art of conversation is not something they experience and is not regarded as important. How do you deal with that? Everything is connected.
	I return to the initial point: unless the Minister can tell us how we are starting to identify the problem with written language and the idea of excellence, we will always exclude that bottom group, and it will always be worse among those suffering social deprivation. How do we deal with that? Better teacher training and recognition is important but there will always be this group at the bottom which will be left behind.
	We have taken the low-hanging fruit in educational improvement. It is understandable that the previous Government took that fruit because, if I had been them, trying to raise standards and wanting a press release to justify what I was doing, that is exactly what I would have done, because the low-hanging fruit is the easiest to reach. How will we get past that?
	I want to show noble Lords how deeply ingrained this is in the education system. I will give you one example from a letter which arrived on my desk yesterday. Someone was told that they could not gain a City and Guilds qualification as a carpenter because they could not finish the English paper. That is probably illegal. We spent a great deal of time on this when debating the apprenticeships Bill. City and Guilds should not give that as a reason not to qualify a person. I leave you with that practical example.
	Unless you get away from the obsessive idea that you must pass in something-maths comes just behind English-and unless you address this properly across the board, such people will always be left behind. We really must address that. If excellence means something more than achieving an extra A-level grade, you will have to address those at the bottom who have problems, which means that you must be able to understand their problems.

Lord Northbourne: My Lords, I am most grateful to the noble Baroness, Lady Perry, for introducing this debate. In the short time available this afternoon, I will try to focus on one simple aspect of the problem, the problem of providing excellence in education for children from disadvantaged families, focusing in particular on those children who arrive in school without having a secure and loving attachment to their mother or surrogate mother in the first three years of their lives. It is interesting that the noble Baroness, Lady Sharp, the noble Earl, Lord Listowel, the noble Baroness, Lady Prashar, and the noble Lord, Lord Addington, have all spoken fluently about the importance of the family as an agent in achieving excellence in schools for children.
	Excellence in education for all will not be achieved until we address more effectively the problems of education in the family in the first three years. A small but important minority of children in this country are arriving in school unable to cope with the challenges of school life because they have never experienced the encouragement and love that they need. Why does that happen? I have made a list of causes, but I probably do not need to delay your Lordships very much on them. There are school-age mothers, mothers with mental health problems or drug and alcohol addiction, or who are subject to domestic violence. Perhaps the majority of those mothers come from homes where they are distressed by loneliness, poverty, inappropriate housing, and debt and often, crucially, have not themselves had any experience of happy family life or of "good enough" parenting. As for the fathers, some may be there to help, but an awful lot are not.
	The children of such families often reject school and fail in school. They often cause trouble in school, get excluded and end up without education. Lacking education, they have little chance of well-being in life. For our society to allow that to happen is both foolish and cruel. It is cruel to the children concerned because it will blight their lives. It is foolish because we as a society cannot afford to have disadvantage handed down from generation to generation in that way. It is an issue of well-being, but it is also an issue of equality and social mobility. As long as we have a cadre of children at the bottom of the pile who are not succeeding, we cannot hope to move towards broadly-based equality.
	What are we doing wrong? When they came into power in 1997, the previous Government were very aware of those problems, and they introduced a number of measures, including the Sure Start programme, Every Child Matters and a raft of other initiatives to help parents to prepare for school. Sadly, they do not seem to have worked. They have not successfully helped the most disadvantaged families. That is because they were introduced as universal services, and the smart parents-I mean smart in the American sense-saw their chance to get in there and get the benefits, but the disadvantaged parents were not confident enough to walk through the door. Some hard-to-reach parents are frightened to walk through the door because they are afraid that when they are identified as not looking after their children too well, those children will be taken away from them. We have to face those problems; we have somehow to learn to target the really disadvantaged parents.
	There are a lot of things that we could do, but I shall not try to detail them-partly because I do not have time and partly because most of your Lordships will be aware of them. We should be much more effective in reducing unwanted pregnancy. It is ridiculous that we have a society in which we have effective and easily available contraception, but the unwanted pregnancy rate goes on growing. We should shape benefit and tax structures to favour those parents who are prepared to make the commitment to live together and bring up their child. We should strengthen relationship counselling. We should radically reform teaching of life skills and relationships in schools, which I believe is coming up in the Government's programme-I very much hope that it will. We need much more support for parents in ante and postnatal services, and so forth.
	Finally, we need a change of heart about the rights of children. Children have a right to family life. I believe that that means that they have a right to decent family life. That implies that there are obligations on parents, which we ought to be thinking about very seriously.

Lord Lucas: My Lords, I am very grateful to my noble friend Lady Perry for initiating this debate. I agree with everything she said, so I shall not repeat it. I declare an interest as the editor of the Good Schools Guide and I declare my sympathy for the Minister. As the Daily Mail will not say: "How many more Ministers have to be mugged before we give them their cars back?".
	I am delighted by the way that our Government are tackling education. I am very much looking forward to hearing the details as they come before us in legislation. Today, I want to concentrate on just two aspects. First, we are quite right to recognise that control, either by the centre or by local education authorities, is not the route to excellence in education; we must concentrate on what is happening at the school level. However, if we are going to do that, and benefit from all the innovation and excellence which is down there, we have to have mechanisms of accountability and means of spreading good practice.
	I am very much with my noble friend Lady Perry in saying that we need to go back to an inspectorate that is intelligent, communicative and supportive-something which is of real benefit to schools. We have the model there: it is the way that it used to be. The best model was the Further Education Funding Council's inspectorate, when it briefly existed. We need to get away from the horrible mechanistic, antagonistic system that we have at the moment.
	To pick up on something that the noble Baroness, Lady Morris of Yardley, said, we need a mechanism for improvement. We need a proper evidence base. How can education never have had a proper evidence base, never have really done its research properly, although it spends a lot of its time doing research? We need mechanisms for spreading good practice. I share the noble Baroness's worry that those that are around are being abolished, but perhaps the Government have a better idea. They must have a better idea, because otherwise we merely get pockets of excellence that never spread.
	Secondly, it is important that education should suit the child. I am delighted that the previous Government abolished the QCA. I very much hope that this Government will go on to demolish most of Ofqual. They have been suppressive, not supportive organisations. They have curtailed innovation. They have imposed their views of what should be happening and not listened to what is happening below them. Whatever replaces them ought to be an organisation that is there to encourage innovation-yes, to control quality but, above all, to get what is good beneath to come through and to encourage the examination boards to innovate as they want. The examination boards are full of experts who want to do new things and who understand, because they are talking to schools all the time, how they could do things better, but who have never been allowed to by the structures imposed on top of them.
	There are now ways of teaching mathematics which are absolutely enthralling, which I would have loved to have experienced. I enjoyed mathematics, but what is available now with the help of computers would take an able student far beyond the limitations of the current curriculum. So much can now be based on a real understanding of mathematics rather than on the mechanistic completion of calculations. That our IT exams do not enable people to interact with modern devices and that our business studies do not provide our students with anything which is valued by business is a disgrace and needs to be set right.
	I have only a couple of other points to make. First, I say to my noble friends Lady Perry and Lord Blackwell that, if we go by the experience of Singapore and other such countries, they have found that fully half of their key entrepreneurs of the future are in the bottom 10 per cent at school. That is the key part on which to focus when talking about education. You must make sure that those people do not leave school demotivated and without the basic abilities that they need to make progress in the world. These people are fundamentally not fitted to academic education, but they are immensely important to the country.
	My noble friend Lord Blackwell is looking at the past. I do not think that selection by examination is the way to go. It has been captured by the middle classes. If the number of grammar schools was to be doubled, it would still be captured by the middle classes. The way to go is selection by choice, which is the way in which my noble friend Lord Baker is going. He is creating schools to which people will go because they want to. People will choose his schools because that is the education they want. They will choose academic schools because they offer the education that they want. An example of that is sixth-form education in Cambridge where there are three excellent institutions-Hills Road Sixth Form College, Long Road Sixth Form College and Cambridge Regional College. People choose the one that suits their particular bent. If we get there, it works very well.

Lord Bichard: My Lords, let me join the whole House in thanking the noble Baroness, Lady Perry, for giving us an opportunity to debate one of the most important subjects of all. When I looked at the list of speakers, two things struck me. The first was that this would be a very high quality debate and, secondly, that speaking at number 20, it would be difficult to say something new and innovative. I will do my best.
	This has been an exceptional debate, partly because many of us in this House have struggled in different capacities over many years to close the achievement gap in this country. Like me, many of us will take pride in our efforts, but will be disappointed, nay frustrated, that we have not been more successful. Perhaps this debate is not just a debate but a chance for us all to rededicate ourselves to the task with even greater urgency and determination. In doing that, perhaps we should remind ourselves that failure does not bring with it just economic and social costs, but huge costs in human terms.
	I shall refer to two groups to illustrate that. Let us take NEETs, which is the awful term for young people "neither in employment, education nor training". We have in this country nearly 1 million young people who we refer to as NEETs. Our performance has long compared poorly with just about every other developed country. Of course, that brings economic and social costs. I was shocked to hear from a senior official in the Department for Education and Skills recently that in the north of England, 15 per cent of long-term NEETs die within 10 years. It is therefore no exaggeration to say that for the most vulnerable children and young people in this society education really is a matter of life and death.
	Another vulnerable group, children looked after in care, already has been touched on by the noble Earl, Lord Listowel. There have been improvements, but that is from a very low base. There are 59,000 children in care in this country, 6,000 of whom are in care homes. They represent 0.1 per cent of the child population. Yet, one-third of all prisoners have been in care; 42 per cent of prostitutes interviewed recently for a paper have been in care; 20 per cent of 16 to 19 year-old women who leave care become mothers within a year; and parents who have been through the care system are twice as likely to lose the right to care for their children. Those appalling statistics have to be linked to the fact that half of all children in care leave school with no formal qualifications at all. Although 8 per cent now go on to further and higher education, that compares terribly with a country such as Denmark where 60 per cent go on to higher education.
	However, if we are to redouble our efforts and rededicate ourselves to this task, we need to be prepared to ask ourselves some searching and perhaps uncomfortable questions. I have five questions. First, do we still seek to impose a one-size-fits-all system on pupils who are so diverse in their talents, their background and their needs? In particular, do we still continue to undervalue vocational education, which is seen by many young people as being far more relevant than the more traditional academic subjects? For me, education is about liberating and developing the talent of every individual child. If that talent is more vocational than academic, we should embrace it rather than accept it reluctantly, as we have sometimes seemed to do.
	Secondly, have we all placed a disproportionate emphasis on the structure of our education system at the expense of standards, content and, most of all, as a number of noble Lords have said, teaching quality? The British are obsessed with structure. We all love it. Politicians and civil servants love it because if you change it, it gives the impression of having done something. But all research points to the fact that the most important thing is the quality of teaching. Do we need to revisit the quality, not just of initial teacher training, but, as has been said, continuing professional development? Could we be more imaginative in allowing the best teachers to help and to support their peers? I think that we could.
	Thirdly, have we drawn sufficiently on the contribution of the many high-quality voluntary organisations which have the capacity and the skills to re-engage young people who are alienated from the system and to deliver relevant education and training to them? For seven years, I chaired one of the largest of those organisations, Rathbone, and we had a good track record. However, I rarely felt that we were seen by the Government, schools or colleges as partners, but more as a convenient backstop.
	Fourthly, have we been too determined to deliver education in traditional settings, by which I mean schools and colleges, when many young people have long since become alienated from those institutions? For me what matters is that young people receive an education. If they are more likely to participate in a work-place setting or some halfway house, so be it.
	Finally, have we realised the potential of creative subjects, such as art, performance, film and design, to capture the imagination of some of these young people? I should declare an interest. I chair a charity called FILMCLUB, which has received generous funding from the previous Government and from this Government. We aim to educate children by screening, discussing and reviewing quality films. We now have film clubs in 5,500 schools. We have 160,000 children every week engaged in those film clubs and 60 per cent of school leaders say that it is an effective way of narrowing the gap.
	Over the years, when I have visited schools and sat in on lessons, I have been struck constantly how arts subjects can inspire and light up young people, many of whom are alienated from the system.

Lord De Mauley: My Lords-

Lord Bichard: We need to ask ourselves those questions if we are going to make changes.

Lord De Mauley: The noble Lord is into the eighth minute.

Baroness McIntosh of Hudnall: I know that I have a very short period in which to speak in the gap and I am very grateful for that opportunity. At the end of this impressive debate, I should like to make two points that I hope the Minister will be able to take into account. My first point concerns buildings in relation to the delivery of excellent education, which I thought would be mentioned more, but was referred to only in passing by my noble friend Lord Knight. In the past couple of weeks, as part of the Lord Speaker's Peers in Schools programme, I have visited two schools which either are about to be, or have recently been, substantially rebuilt under the Building Schools for the Future programme. It is absolutely clear that a new, properly configured, light, bright and welcoming environment makes a huge difference to the way in which children learn, and the enthusiasm with which they go to and remain at school. I hope that the noble Lord will bear that in mind when thinking about how the school buildings programmes are taken forward from now on.
	Secondly, I am sure that noble Lords who have heard me before will expect me to say that I hope that the Minister will not forget the value of the arts and culture in delivering education. I want quickly to mention two organisations with which I am involved to illustrate two different ways in which the arts are important in education, and two different ways in which cutting funding will be very deleterious. The first is an organisation called Artis Education, a small business which receives no public funding whatever; it is a commercial business. The noble Lord, Lord Bichard, knows it well because he was instrumental in setting it up. It trains performers to go into schools and deliver a highly structured and extremely successful programme which complements the national curriculum. All the heads who have bought into this programme-I use the word "bought" advisedly because they have to pay for it-have discovered that it adds greatly to the quality not only of their children's learning but of their enjoyment of education. However, head teachers have to pay for it out of their discretionary spend, and if that is reduced it is less likely that they will be able to buy that kind of enhancement to their curriculum.
	The second organisation with which I am involved is the Roundhouse in Camden. It is funded publicly, although only to a limited extent, and raises a huge amount of money from the private sector and from the box office. It uses that money to contribute to a programme of creative learning for large numbers of young people, including those to whom the noble Lord, Lord Bichard, referred-the unattractively named NEETS-who want to engage creatively with the arts. They take what they learn at the Roundhouse back into their education if they are still in education, and forward into their working lives if they are not.
	If organisations such as the Roundhouse are not able to sustain those programmes, it will be a tremendous loss to those young people. I hope the noble Lord, who I know is convinced about the value of the arts in education, will make sure that they stay high on the agenda of his department as we go through the next difficult period.

Baroness Morgan of Drefelin: My Lords, I support my noble friend's passionate intervention. She has a great deal of expertise in these matters and it was very helpful. I congratulate the noble Baroness, Lady Perry, on introducing this important debate.
	It is tempting for an incoming Government to believe that they are starting from zero and to dismiss everything that has gone before, and the noble Baroness is right to secure the debate to ensure that that does not happen. However, it seems to be a temptation to which this Government are particularly susceptible. In fact, almost everything before May 2010 has been removed from the DfE website and consigned to the national archive, if it is available at all, including much good research and useful material which is entirely apolitical. It is therefore important that we look back as well as forward. It is a big mistake to remove that perspective, as,
	"those who cannot remember the past are condemned to repeat it".
	I quote, as many will know, George Santayana, the Spanish philosopher.
	The evidence shows that there have been many achievements so far in our schools and children's services and we have heard a great deal about them. They have been independently verified and should be built on. No wise policymaker would ignore them. I welcome the points made by the noble Baroness, Lady Perry, about the success of our academy programme and the importance of the introduction of the diploma from which a great deal can be learnt. However, I take exception to the assertion that we were engaged in levelling down. Let me make it absolutely clear that the opposite was the case. We strongly believe that every school should be a good school and that all children should have access to excellence, as the right reverend Prelate the Bishop of London described so eloquently.
	Let us consider what we encountered in 1997. There were no children's centres or free nursery places; the school estate was crumbling; we had to work with a demoralised teaching profession; and more than 1,600 schools-half of all schools-achieved less than 30 per cent of pupils attaining five good GCSEs. That was our legacy. However, because of our relentless efforts in school improvement, now only about one in 10 schools display such a poor showing-but that simply represents how much more there is to do. We delivered free nursery places to all three and four year-olds and we committed to and set in motion the extension of that to 2,500 disadvantaged two year-olds, a scheme which the Coalition Government have agreed to continue. Alongside this, 3,500 of the much celebrated Sure Start centres were established and thousands of families with a disabled child-this point has not yet figured in this debate but I am sure it will arise in many others-were given access to the kind of short breaks they so desperately need in order to continue supporting their families and children.
	I give the noble Baroness, Lady Perry, full marks, if I may be so cheeky, for recognising that we now have the best qualified, strongest teaching profession ever. The noble Lord, Lord Bew, and others also recognised this. This has not come about without a concerted effort in investment and professional development. It did not happen without effort. Across our country, millions of children are going to school no longer having to put up with leaking roofs and peeling walls because they attend one of the 4,000 brand new or refurbished schools that have been built in the past 13 years.
	Our young people are achieving the best ever exam results and, when we left office, improvement was taking place fastest in the poorest areas. That is not to say that there is not a great more deal to do, but it does represent our potential to do more. As the noble Lord, Lord Bichard, said, we should recommit ourselves to the challenge of making a real difference for all our children.
	I remind the party opposite of what has been achieved by teachers, teaching assistants-we must not forget teaching assistants because they have such a key role-parents and pupils, because we need to learn from the past and there is much more to do. The Government should avoid the urge to reinvent the wheel, which children in this country definitely cannot afford, and should learn from the experiences of our schools and children's services over the past 13 years.
	What kind of lessons can we learn and what conclusions should we draw? I have picked out three lessons. First, when we were in Government-many noble Lords around the Chamber have echoed this-we learnt that what happens in the classroom is crucial for children's education; educational achievement does not come about otherwise. We also learnt that what happens outside the classroom matters a great deal, too, especially what happens at home. The noble Baroness, Lady Sharp, the noble Earl, Lord Listowel, and the noble Baroness, Lady Prashar, described that parents are the single biggest influence on how well children do. That is why, when in government, we invested in programmes to support parents to help their children learn; and it is why we funded voluntary organisations to work in partnership with us locally and with families. What are the Government's policies for supporting parents to help their children to succeed at school, especially those parents who did not do so well themselves and who will not necessarily know how best to help their children to do so? What policies will the Government promote to help those children who do not have families? Is the answer that such parents should simply apply to set up their own free school? I am sure that is not what the Minister would say.
	The second big lesson we learnt over the past decade is that-not only here but across the world-the early years of a child's life are the most important in their development. If they get the right educational help then they are set up for success. This is especially important for disadvantaged children, who can either race ahead or be held back at this stage. The crucial ingredient is high quality early years education provided by skilled, kindly, professional staff who make early learning playful and fun.
	The spending review document states that the Government will return Sure Start to its "original purpose" and that they will encourage more private and voluntary sector providers to get involved. That raises some big questions. For example, what do the Government mean by Sure Start's "original purpose"? If, as seems possible, they mean more focused support for those children left furthest behind, how will they identify those children? How will they achieve this at a time when we know that overall resources will be reducing in real terms, particularly for children's services? Does it mean that provision will be taken away from some children and families who are receiving it now? Since we know that there is a tendency for "services for poor children" to become poor services over time, how will the Government avoid it? It is a real challenge.
	Given that inspections show that the best-quality early-years education is more often to be found in the public sector, how will the Government ensure that standards continue to be high if there is simultaneously less money and more involvement from private and voluntary providers? Will they give private and voluntary independent providers the extra help that they need for training? The key ingredient in early education is undoubtedly its quality and-what we are talking about today-excellence.
	We have learnt that many children whose educational achievements are held back by other barriers in their lives, such as disability, special educational need or family problems, can overcome them if they get the right help at the right time, ideally before the problems have become too entrenched. That puts a premium on schools having strong working relationships with other services for children, enabling them to get the effective professional help that they need at the earliest possible opportunity. Such help could take the form of social work, educational psychology and mental health support. That is why, when in government, we put in place children's trusts to reinforce those positive working relationships between schools and other professionals. But the Government have said that they will dismantle children's trusts. Their changes to the provision of local health services will also cause chaos. The Secretary of State for Education seems to want to create a free market for schools with autonomous institutions competing with each other. Is this a recipe for fragmentation and dislocation? What will the Government do to make sure that that is not the outcome?
	I hope that schools and local authorities will not be left to deal with these dilemmas alone, because, if they are, it is children who will become the biggest losers.

Lord Hill of Oareford: My Lords, I am very grateful for and touched by the good wishes that I have received today. I ask noble Lords not to be too kind. I can cope with being duffed up, but acts of kindness creep up on one a little harder. I felt rather sorry for the young men who attacked me last night when I realised that the main thing that they had made off with was my speaking notes for today's debate. When they find what they have got, they might be a trifle disappointed, but I hope that noble Lords may be a little more forgiving.
	As I picked myself up and felt various bumps and bruises, I reflected on the connections between what happened to me and today's debate. It seems that the connection is this: if those boys had a better education and home life, a point made by the noble Lord, Lord Northbourne, perhaps they would not have been hanging around on street corners waiting to jump on unsuspecting Peers from behind and hit them over the head. That is an important point to bear in mind in what we are debating today.
	Like all noble Lords, I congratulate my noble friend Lady Perry on securing this debate. I do not need to tell the House about her huge experience in education, but I take this opportunity to express my thanks to her for the generous advice that she has given to me since I came into the House and to say how much I have benefited from it.
	Successive Governments have set themselves the goal of achieving excellence in education-I think that there is no difference between us on that. As the noble Baroness, Lady Morgan of Drefelin, knows, since we have been debating with each other, I have, I hope, always been quick to say that there are many things that the previous Government did on which we are seeking to build.
	I associate myself strongly with the notion of excellence, whether that is academic, as my noble friend Lord Blackwell argued, or vocational, as my noble friend Lord Baker and the noble Lord, Lord Bichard, pointed out. Excellence, whether vocational or academic, is something that we must strive for and, as my noble friend Lord Addington said, we must bring out the best in every child. Children are all different, but the key is aspiration. I have seen that aspiration in non-selective maintained schools, academies and selective schools.
	However, I think that there is agreement-the noble Lord, Lord Knight of Weymouth, was very honest about this-that, in spite of the best efforts of successive Governments, our education system is still failing too many and, most of all, it is failing the poorest in our society. We have many excellent schools, but we have too many schools that are struggling or coasting-I listened with care to what the noble Lord, Lord Bew, said about the Northern Irish example. Overall, as a nation-we probably know the figures-four in 10 pupils do not meet basic standards by the age of 11 and only half manage at least a C in both English and maths GCSE. What makes it worse is that poor performance is so powerfully concentrated in the areas of the greatest disadvantage, as the noble Lord, Lord Parekh, said. It is important to make sure that those children continue to receive help. The pupil premium will provide such help, particularly to children from ethnic minority backgrounds.
	Only a third of children eligible for free school meals reach a good level of development by the age of five, compared to more than half who are not. That gap continues through primary and secondary school until, at 16, pupils entitled to free school meals are only half as likely to achieve five good GCSEs but more than twice as likely to be permanently excluded. Out of that cohort of 80,000 children on free school meals, only 45 make it to Oxbridge. As the noble Lord, Lord Ramsbotham, said, one sees these problems at their most intense and concentrated in our prisons.
	Other nations have been more successful recently in educating more and more children to a higher level. I shall not go through the figures, because we are short of time and we are, I think, familiar with them. I agree with the noble Lord, Lord Knight of Weymouth, that debate about education in this country has been conducted too much in terms of looking backwards and inwards. Some people in my party in particular have prefaced the argument by saying, "Can we not go back to?". It is very much my view and, I think, that of the noble Lord that the real test for us is to look outwards and compare ourselves with the best internationally. We will have a much more productive debate about education if we frame it in those terms.
	Therefore, one of the first things that I did on becoming a Minister was to look at OECD research into the best-performing and fastest-reforming education systems. Three essential characteristics seem to mark out all those different jurisdictions. First, those jurisdictions seem to be guided by the principle that more autonomy for individual schools drives up standards. Secondly, the highest-performing education nations invariably also have the best teachers-no surprise there. Thirdly, they all have rigorous systems of accountability, which has been mentioned today.
	We can see examples of these lessons being pulled together in the United States, where President Obama is promoting greater autonomy by encouraging charter schools, while also giving extra support to programmes designed to attract more great people into teaching and leadership. This also seems to be working in Canada, Sweden and Singapore. We know from experience in our country that giving schools greater autonomy seems to work. We know from the academies programme, which was based originally on the CTC programme but then built on and rolled out by the previous Government, that overall results have improved faster in academies than in other maintained schools.
	I welcome the words of the right reverend Prelate the Bishop of Wakefield about Trinity Academy and I am grateful more generally for the part that the Church of England has played in our school system, which was a point made by the right reverend Prelate the Bishop of London. Last year, overall, academies improved twice as quickly as other schools.
	I pay tribute to my noble friend Lord Baker and the remarks that he made about university technical colleges. I have had many conversations with my noble friend about those matters. I am conscious of the support that he said that he had received from the noble Lords, Lord Adonis and Lord Knight of Weymouth. It is my intention to build on support that has previously been given and do everything we can to get as many UTCs up and open, giving excellent vocational qualifications and training as soon as possible. To pick up on a point made by my noble friend Lady Perry of Southwark, I also hope to have more apprenticeships.
	On academies, this House knows better than anywhere that we are now rolling forward our programme. Let me update the House. Since the beginning of the school year in September, 57 of the outstanding schools have converted to become academies. That number is now increasing month by month and more schools are coming forward, keen to convert. That is on top of an additional 64 new traditional academies. In all those schools, academy heads have the power to tackle disruptive children, protect and reward teachers better and give children the specialist teaching that they need. In the coming weeks, we will set out how more schools will be able to apply for these academy freedoms.
	On free schools, we announced the first 16 projects that should be up and running by next September. Given that it typically took three or four years to set up a new school, the fact that we might have one so quickly is very encouraging. We have more projects in the pipeline that could open by next September.
	The noble Baroness, Lady Morris, talked about the difference between structures and teachers, a point that was raised more generally today. I am certainly not someone who believes that the answer to everything is structures. The point of our reforms is to give teachers more freedom within those structures to get on and do what they do best. I agree with my noble friend Lady Perry. The most important people in improving standards are clearly heads, teachers and teaching assistants.
	As far as that is concerned, we will publish our first education White Paper before Christmas. I can tell the House that, in that White Paper, teachers and other education professionals will be at the front and centre because everything else that we want to achieve flows naturally from the quality of the workforce. I agree with the point made repeatedly this afternoon: we have the best generation of teachers in our schools. I will reflect on the point made by my noble friend Lord Brooke of Sutton Mandeville about the difficulty of attracting men into primary schools in particular. I was lucky recently to present awards at the Teaching Leaders' annual event and see the enthusiasm of those young teachers who are progressing up the profession. That told me clearly that that was the kind of talent that we have to support, as we do Teach First, which has been referred to already. We have doubled the size of the programme that we inherited from the previous Government and have extended it to primary schools for the first time.
	In the White Paper, we will unveil a whole range of further proposals to ensure that we attract the best possible people into education, to make it easier for talented people to change career and to enable teachers to acquire deeper knowledge and new qualifications, for which the noble Lord, Lord Bichard, eloquently argued.
	We can also help with discipline and behaviour. Among undergraduates, the most commonly cited reason for pursuing a profession other than teaching is a fear of not being safe. We will build on the action that we have taken to remove the ban on same-day detentions and we will give heads and teachers stronger search powers, with further changes, including simplifying the use of force guidance and how we will protect teachers against false and malicious allegations from pupils and parents.
	Once professionals have the power that they need to feel secure and are able to develop their skills and knowledge, we have to create more room for them to use them. In recent years, the national curriculum has been bent out of shape by the weight of material in it and some overprescriptive notions about how to teach and how to timetable. That is an area that we will look at. Later this year we will set out how we will carry out the review of the curriculum. I know that many noble Lords will want to be part of that process. The principle behind the curriculum that we want to construct is that it will be informed by teachers and experts, will have greater flexibility and will be based on the best global evidence of what knowledge and concepts can be introduced to children at different ages.
	We also spoke in the debate about accountability, which is an important theme. Autonomous schools must have high-quality people, but they must be properly accountable to parents and local communities. We cannot return to the situation where parents and professionals were in ignorance about what was going on in schools, which was the point made by the noble Baroness, Lady Morris, and with which I agree. I also agree with the point made by a number of noble Lords about school improvement. We need to think carefully about how we make sure that the excellent practice that exists in schools continues to be shared as widely as possible. Nobody wants to see a situation where we have schools operating as islands within the education system. We want to ensure that good practice is shared school to school as much as possible.
	We need rigorous external assessment. Tests can be improved and refined-and they must be-but parents need independent external assessment. We want to publish more information to shine a spotlight that parents can understand and help to hold schools to account. We are also looking at ideas behind an English baccalaureate, which will help to drive excellence, built around a core group of academic subjects including a modern or ancient language and a humanity. We are looking at the role of Ofsted and I will reflect on the points made to me by my noble friend Lady Perry in that regard.
	I will just say a couple of words about spending, since the issue has been raised. During this debate, we have spent £12.5 million paying the interest on the country's debt. That is equivalent to the annual salaries of 371 classroom teachers, so we need to do something about cutting that debt. Within that, we have managed to prioritise education and, at a difficult time, to find £2.5 billion for the pupil premium, to fund an increase in places for 16 to 19 year-olds and to extend the entitlement for free education for three and four year-olds to disadvantaged two year-olds. I take the points about the importance of tackling education young and supporting the young and families and will reflect on those.
	This has been an excellent debate. I will follow up any individual points that I have failed to respond to and hope that the House will forgive me for that because of the constrained time. I express my thanks to my noble friend Lady Perry. The whole House agrees with the stated ambition of providing excellence in education. It is our duty as a Government, but more generally as a society, to pursue that goal and this Government and I will do all that we can to ensure that all children have the best possible chance to succeed.

Baroness Perry of Southwark: My Lords, we have run out of time, so it only remains for me to thank all noble Lords who have spoken with such eloquence and expertise on the subject. I beg leave to withdraw the Motion.
	Motion withdrawn.

Healthcare
	 — 
	Debate

Moved By Lord Hunt of Wirral
	To call attention to the Government's policy on patient-led healthcare, the focus on clinical outcomes, and the role of health professionals; and to move for Papers.

Lord Hunt of Wirral: My Lords, I beg to move the Motion standing in my name on the Order Paper and to say how delighted I am to initiate this debate today, especially following the Government's commitment last week to protect health spending. As the Chancellor of the Exchequer said, in presenting the Government's spending review:
	"But to govern is to choose, and we have chosen the national health service".
	We would do well to remind ourselves that the Chancellor also said:
	"That does not mean that we are letting the Department of Health off the need to drive real reform and savings from waste and inefficiency. Productivity in the health service fell steadily over the past 10 years, and that must not continue".-[Official Report, Commons, 20/10/10; col. 959.]
	Nevertheless, overall NHS spending will increase in real terms over the course of the spending review period, and it is right that we should now have the opportunity of setting out the views of this House on the Government's healthcare plans. Their proposals to put patients at the heart of the NHS, to bring greater focus on clinical outcomes, and to empower health professionals are set out in detail in the White Paper and in all the consultation papers and announcements that have subsequently been issued.
	Every Government must grapple with concerns over medical research and screening, accidents-especially in the home-obesity and smoking, to name some of the more perennial concerns. The impact on children's health of all those arguments over MMR and the fallout from the last Government's handling of the swine flu epidemic have also emphasised the central importance of vaccination to government health policy. I very much hope that my noble friend will give further details as to the Government's approach to this critical area.
	Before I go further, I need to declare my interest. For several years, I was ultimately responsible for the National Health Service in Wales, and my ministerial team and I worked closely with John Wyn Owen in developing our clear policy,
	"to add years to life and quality life to years".
	I should also remind the House that for 41 years I have been a partner in the national commercial law firm Beachcroft LLP.
	Many of the Government's commitments will require primary legislation, and a Bill is due to be introduced later this year which will attract considerable attention not only from within the NHS but from firms in the private health sector and from professional advisers. As a former science Minister, I was particularly pleased with the generous treatment of the science budget, which will also enable the investment of £220 million in the UK Centre for Medical Research and Innovation at St Pancras, and also to fund the Laboratory of Molecular Biology in Cambridge.
	The programme set out by the Government is undoubtedly an ambitious one, particularly in its vision of patient-led healthcare. Few will dispute the merits of giving patients more choice and control. Much debate has already focused in this respect on the shift of responsibility for commissioning most healthcare services in England from primary care trusts to local consortia of GP practices. This is intended to bring decision-making as close as possible to patients, in what the Government terms,
	"no decision about me without me".
	Much has been said, and will continue to be said, in relation to the proposed role of GP consortia, on the challenges that this will present to GP practices and other stakeholders involved in commissioning; and the support which GPs will need to commission services and contract with service providers effectively. However, these discussions should not blind us to the fact that the Government's commitment to giving patients a choice of any provider, choice of consultant-led team, choice of GP practice and choice of treatment alone will entail more sweeping changes to how the NHS operates, much more sweeping than many commentators thought only six months ago.
	As president of Case Management Society UK, I would like to stress the contribution that case managers can make to the better allocation of resources, and also to the creation of more joined-up treatment for patients. I therefore hope that we shall see an expanded role for case managers as the NHS evolves. As experts in the process of communication and co-ordination, case managers can help patients who have to make informed decisions about their individual healthcare and also provide an opportunity to shape the future of healthcare services.
	"Choose and book" has already greatly enlarged the degree of choice that patients or their GPs can exercise in relation to their treatment. The emphasis on the choice of named consultant-led teams for elective care by April 2011, when clinically appropriate, will be a very positive development, and one supported by the Royal College of Surgeons, which has briefed us for this debate and which is helping to lead the way in developing and using outcomes data. I know that my noble friend and his colleagues are rightly concerned to ensure a genuine level playing field for providers of care. Ultimately, effective and fair competition under a rules-based system will stimulate innovation, bring forward extra capacity and underpin genuine patient choice. Notwithstanding the statements of the Secretary of State's predecessor in favour of the NHS as preferred provider, many privately owned operators already provide additional capacity through the Extended Choice Network. As a means of using all available beds and resources to assist in the major task of improving the NHS, this framework has been a success for patient, taxpayer and private sector alike. I understand that the coalition Government are planning to build on this framework in rolling out the new "any willing provider" framework.
	The creation of a level playing field will require not only a focus on high-profile initiatives such as the right to choose a consultant-led team but a detailed attention to the minutiae of commissioning. The duration and termination provisions of the contracts which are rolled out under the framework, the way in which these contracts are awarded and the number of separate contracts that providers will need to bid for and perform may in practice have as much impact on the creation of a level playing field between providers as some of the more publicly debated issues. Of course, plurality of supply in the NHS will need to go hand in hand with a regime for the so-called failing hospitals. This is an area of great complexity from a policy, financial and legal perspective, but one which I hope that the Government will not shy away from in setting out their reform proposals in more detail. We must ensure that patient choice becomes a reality for all patients.
	Patients will need access to information, and I welcome in this context the Government's proposals to centralise all data returns in the Health and Social Care Information Centre. Informed choice will be about recognising the importance of providing more insightful information to patients, but also that,
	"different people and groups in society access information differently and need it presented in different ways. We must ensure the right information is available and presented in a relevant way to those who could otherwise be excluded".
	My noble friend has rightly characterised these plans as requiring an "information revolution". That brings me to clinical outcomes. Few members of the public or the medical and nursing professions will disagree with the Government's aims to hold the NHS to account against clinically credible and evidence-based outcome measures and remove process targets with no clinical justification. The public will surely welcome their proposals that payments to providers should reflect outcomes, not just activity, and provide an incentive for better quality. The same is true of the plans to pay drug companies according to the value of new medicines and with a view to ensuring better access for patients.
	The Government's focus on excellence in the NHS emphasises that there is a lot more work to be done to ensure consistently excellent performance in all areas of care. This is about more than just enshrining duties into law; it is about ensuring that the drivers of excellence in the NHS are identified, implemented and promoted.
	One area is, of course, cancer treatment. I know that my noble friend Lady Finlay of Llandaff will on 11 November give us all an opportunity to debate the measures necessary to improve the quality and quantity of life for people with cancer, so I will not say anything further on that-although the Minister may want to say something further.
	It would hardly be possible to comment on the setting of new quality standards in the NHS without paying tribute to the excellent work of the National Institute for Health and Clinical Excellence. At a time when the future of certain valuable arm's-length bodies remains uncertain, the steps which the Government are taking to ensure the independence of NICE and its core functions are encouraging. Of course, the Government have also indicated their intention to empower professionals and providers, give them more autonomy and make them more accountable to patients through choice, and to the public through more formal means of accountability. I read carefully my noble friend's speech to the King's Fund. He said, "It boils down to trust". How right he is.
	GP consortia will be accountable to the proposed new NHS commissioning board and it must be the clinicians and their patients in consulting rooms and clinics, not the board, who are the so-called "NHS headquarters". The independence of this board will deliver on the promise of taking political micromanagement out of the NHS that so many Ministers have made in this House, but few, sadly, have been able to honour.
	Nor will this promise be honoured in just the commissioning of care. The same degree of independence will be given to Monitor in its new incarnation as the economic regulator of healthcare providers. Several of my colleagues may well want to refer to that. We of course need greater autonomy at the operational level, and colleagues may recall the strong reservations of my noble friends regarding the constraints imposed on all those powers given to, for instance, foundation trusts. We had doubts about the constraints imposed on the freedoms that were originally promised. As part of the Government's commitment to,
	"create the largest and most vibrant social enterprise sector in the world",
	foundation trusts will at last be given those greater freedoms. My goodness, they are going to need them, and we await those further announcements with great interest.
	In conclusion, I recognise that there is a place for effective performance management in the NHS. This has yielded promising gains in productivity in some regions, such as the south-west. Handing more freedom to our successful foundation trusts will be the key to unlocking greater innovation in the NHS. We also welcome the additional responsibilities which are to go to local authorities, and we will be monitoring those very carefully. This will all require investment in infrastructure and a clear focus on the management of NHS assets, informed by the skills of those organisations with particular experience in the field of asset management. The White Paper does not outline in detail what will happen to, for instance, the LIFT schemes to which primary care trusts are party. This is clearly an important area, as well as one that is ripe for fresh thinking. We look forward to hearing from my noble friend on that.
	My noble friend's task in bringing these reforms to fruition will be daunting. These are the most important reforms to the NHS since 1948. It is critical that we get them right and move the debate from one about structures and processes to one about priorities and progress in health improvement for all.

Lord Winston: My Lords, I congratulate the Government on a wonderful, beautifully written document-the White Paper, Liberating the NHS. Finally, the NHS is to be freed. The document's honeyed tones and warm aspirations are sweetness and light. Its expressions of good intentions will easily deceive less well informed readers. However, to leave aside the aspirations, to which I shall return, the one thing that the NHS does not need is another reform. That is why in opposition Mr Cameron promised to halt the merry-go-round of organisational change with which the NHS had been previously inflicted. This promise was countersigned by a pledge by Mr Clegg, the Deputy Prime Minister.
	I have absolutely no desire to embarrass the noble Earl, Lord Howe, for whom I, like so many of us, have genuinely a huge regard, but we have already learnt how trustworthy this Government as a whole are. So this merely minor change-no merry-go- round-means a reorganisation in which all primary care trusts are to be liquidated, all hospitals will become foundation hospitals, strategic healthcare authorities are to be abolished and the responsibility for public health will become part of the remit of local authorities. This does not seem to be so minor after all-more of an amazing big dipper. In this battle for the NHS, more than three-quarters of the £100 billion NHS budget will be devolved to general practitioners for administration.
	Over the past few months, we have heard a great deal about the legacy left by the previous Government. Forgive me if I feel angry at this; it is not often that I do and seldom have I felt as angry. The negative tones have been the cornerstone of an excuse for the severest cuts in public spending in living memory. This Government's pronouncements, on the whole, are not to be trusted. If their pledges on the NHS reforms are void, so are their promises on the ring-fencing of NHS funding. If we want to consider a legacy, perhaps we might recognise that the Labour Government left the NHS in its healthiest state for decades-a position that this Administration have inherited.
	In spite of the Government's assurances, the NHS is already being cut. Managers have been told to find £20 billion in efficiency savings if widespread closures are to be avoided. To give just one other example, in London the deaneries are threatened. Perhaps the Minister can confirm that, where so much healthcare is needed and where the cream of our young professionals is trained, junior hospital posts are facing a cut of 14 per cent next year. As I understand it, 70 key training posts in general medicine out of a total of 300 are to go-perhaps the Minister can confirm this-and another 70 posts from the other specialities are to be cut by 2014.
	If the King's Fund has calculated correctly, the reorganisation will cost the NHS between £2 billion and £3 billion, which will be taken from patient services. Consider this for a moment: the pressure of population change, the incidence of chronic illness, the rising age of our population, inflation and the rising expectations of patients mean a real cut in resources. The biggest problem will almost certainly be in chronic care. The massive cuts proposed in social care and welfare services will inevitably result in increased pressure on what we can now see is becoming an already underfunded NHS.
	What about research? Here is another unbelievable sleight of hand by the Government. Some of the so-called ring-fenced NHS research budget will almost certainly come from the other research councils. I declare an interest as a member of the Engineering and Physical Sciences Research Council. We already fund a huge amount of healthcare research, as does the BBSRC. We will be asked increasingly to contribute substantially, at the risk of other research. We will be heavily pressured on our own so-called ring-fenced budgets. Meanwhile, regarding NHS R&D carried out by the NIHR, if we are talking about assessing outcomes, how is its performance to be evaluated? That will certainly not, it appears, be anything like as rigorous as the superb work of international quality, funded by the research councils, in our top research universities. Here, surely, is a case for government scrutiny.
	Front-line care is already threatened. The dulcet tones of the White Paper with its emphasis on patient choice and outcomes are a smokescreen. Of course patients would like choice, whatever that means, but what they really want is competent, efficient medical care. I recently went to a maternity ward in one of the most famous maternity hospitals in the country to visit a relative of mine in her 20s, an NHS patient, who had recently given birth to a premature baby at 35 weeks. Her GP had given her the choice of three different hospitals and she had chosen this hospital. She was four days post-delivery and she had not seen a doctor. Her blood pressure had been 200 millimetres of mercury-a situation in which she might even have had a stroke or a seizure-but she said that she had not been seen by a doctor. She was sitting there trembling with worry. She was scared stiff. What she wanted was a doctor to listen to her and to talk to. Even though it is some time since I left the health service or have done any medical practice, I felt obliged to examine her. I went to see the nursing staff and asked whether I could speak to the house surgeons. None was available, so I asked to speak to the registrar. They did not know the name of the registrar. I had to phone the central switchboard to find out who the on-call registrar for obstetrics and gynaecology was. It was only when I left the hospital that there was suddenly an outpouring of care and three doctors visited my relative in about five minutes.
	What about outcomes? Outcomes depend so much on social circumstances. Equity and Excellence: Liberating the NHSmentions cancer, stroke, asthma and so on, but the outcomes of treatment depend on the circumstances of the patient. What we learn more and more, certainly with epigenetics, is that what happens to us in early age also plays a part. What happens in a child aged two or three can have far-reaching effects on whether that child is more prone to diseases such as stroke in 60 years' time. How do you measure those kinds of outcomes with the possibility that this White Paper offers?
	Finally, to leave the-

Baroness Northover: My Lords, I think that I need to remind noble Lords, as the noble Baroness, Lady Farrington, would always remind us, that this is a time-limited debate. When the clock reaches four, noble Lords' time is finished.

Lord Winston: My noble friend Lady Thornton and I have agreed to split our time, which is why I went on for the extra time. I shall finish with one sentence. If we really want to improve the health service, we should make certain that doctors have enough time to listen to patients and that nurses are not involved with so much paperwork that they cannot speak to patients, we need to improve training by better investment, we need to renegotiate the EU working time directive and we need to make certain that hospital doctors work in teams so that there is proper continuity of patient care.

Lord Alderdice: My Lords, I declare an interest as a recently retired consultant psychiatrist who spent his life working in the NHS. I am married to a consultant pathologist in the NHS. My brother is a consultant in the NHS, as is my sister-in-law. My brother-in-law is a general practitioner in the NHS. I therefore speak not from the vantage point of academia or any glamorous speciality in central London but from that of psychiatry and general practice in the regions. From my perspective, the NHS is broken and needs fixing.
	What are the problems that affected me during my work? Increasingly over the past 15 or 20 years, decisions were being made by a larger and larger bevy of managers and administrators at every level and increasingly decisions were being made, quite naturally, more for the benefit of the management process than for that of the clinical process. As a clinician, you could go to meetings-if you could get to them and if you were invited, and increasingly you were not-and find yourself being berated because your clinics were getting larger because you were going to the meetings, or you could not go to the meetings and the decisions would therefore be made in your absence and without any attention being paid to them. The increasing focus on managerialism over the period of the previous Government meant that clinicians were increasingly ignored. My generation thought increasingly of retiring from the NHS because they felt frustrated, not by terms and conditions of service, which improved, but by diminishing morale, as what they really wanted was the freedom to make clinical decisions.
	Decisions were increasingly centralised. Targets and decisions were made in Whitehall and, with the best will in the world, what looks to be the right thing from a Whitehall perspective does not feel like the right thing when you are operating at another level. It is quite true that devolution has helped. For some time, we have had four national health services in the United Kingdom, which has certainly improved things, but the possibility for that improvement through devolution in Scotland, Wales and Northern Ireland happening in England is minimal because of the sheer size of the country. If the benefits of devolution in Scotland, Northern Ireland and Wales were to be achieved in England, it would require further devolution to local government level. Here, there is evidence of the possibility of benefit.
	In Northern Ireland, because of devolution, we had proper, full integration of health and social care, which meant that it was possible for me to co-operate with social workers, that in-patient was not divorced from out-patient, that hospital care and community care were seamless and that the hospital did not soak in all the money and resources from the community whenever there were inevitable pressures. There are benefits to be had, but England needs to learn the benefits that Scotland and Northern Ireland, in particular, and, to some extent, Wales have already achieved.
	The most important thing was the recognition of the importance of engaged and informed patients. Why? It does not matter how clever a doctor is, even if he can afford to make the right prescription; if the patient does not comply with the treatment, it does not improve the situation and we know that, when the research is done, patient compliance is massively lower than most doctors think. However, it goes wider than that. In my own work, it is quite clear that the fundamental difference is not the prescription of medication but the change in the culture and lifestyle of the patient. That happens only when you have a fully engaged patient-an active citizen-who is taking responsibility. Those are the principles that I see reflected in the Government's policy and that is why I am so enthusiastic about it as a doctor.

Baroness Masham of Ilton: My Lords, in the few minutes that I have, I want to speak on patient safety. I know that all patients, wherever they are treated or looked after, desire safe, good-quality care. Patients and health professionals should come together to achieve good clinical outcomes. There should be co-operation and good communication between all professionals so that patients receive what they need.
	I am president of the Spinal Injuries Association and a member of the Patients Association. We have been horrified by the appalling standard of care that left Jamie Merrett, a high lesion tetraplegic who was living at home using a ventilator, severely brain-damaged when an inadequately trained agency nurse turned it off. Jamie, an intelligent man, felt that his care was often inadequate, so he had a camera and video equipment installed in his bedroom to try to safeguard himself in his vulnerable position. I have spoken to his sister and next-of-kin, Karen Reynolds, who told me that they had contacted the PCT several times to alert it to the inadequate care.
	In this tragic case, there seem to be unanswered questions. Will the Minister look into this case? Does the Filipina nurse who turned off the respirator and did not know how to resuscitate Jamie have a PIN? Had her qualifications been checked? Was she qualified to work in this country and on a ventilated patient? Jamie and his sister have been let down by many people who had responsibility for his case in Wiltshire. People living with ventilators need to trust those who have responsibility for their care. This case, which has been highlighted in the press, especially by the BBC in "Inside Out West", might otherwise have been covered up. Many people living with such equipment may also be fearful of this dangerous situation, which must be rectified. When does the Department of Health expect the National Leadership Council to respond to proposals to improve the training quality of NHS managers? Does the Minister agree that healthcare assistants should be registered?
	More seriously disabled people are now living in the community. At the moment, it seems that anyone who cannot get a job goes into caring. I know that the Royal College of Nursing is concerned about this. Vulnerable patients need protection. Not only do we want honest, well trained nurses who understand how to use the necessary equipment, but there need to be well trained, honest care assistants who are registered. The Minister has responsibility for primary healthcare. I hope that he will not let down these vulnerable patients and their families, who need a safe NHS-safer than it is now.

Baroness Fookes: My Lords, unlike many of the contributors to this debate, I speak only as a lay man, but a lay man who is interested in the future of the NHS. I welcome the general thrust as set out in the Government's White Paper. All I ask is that the revolutionary changes that are being made are made with particular care and sensitivity. I have seen a number of changes from the outside over the years and I know that, whatever happens, for those directly involved it is a period of great upheaval, anxiety, uncertainty and worries about how it will all shake down. I hope that this will be done sensitively, and that after that there will be a period of real stability. Thereafter, if changes need to be made, I hope that they are made on a steady basis so that we have evolution, not revolution.
	I particularly welcome the idea of the patient being at the heart of the NHS. When I was young and naive, I would have assumed that that was bound to be the case. Experience has taught me, however, that that is not always the case-one can get very lost in systems, management and all the rest of it-so I am glad to see this brought forward. I have a tiny niggle about the expression "patient-led". It could be considered ambiguous, and I would rather have the term "patient-centred". As long as we get the actual work done so that it is patient-centred, though, the current expression is fine.
	There are difficulties for patients. I shall use one small illustration from an acquaintance of mine who has a rather rare illness that has a number of appalling side effects, so that effectively she is suffering from a number of illnesses at the same time. That necessitates not one consultant being involved in her care but several. There came a crisis point when there were directly conflicting pieces of advice from two consultants. What were the unfortunate patient and her husband to do? One could argue that it should be the GP bringing all the threads together, but I suggest that, with a rare illness involving consultants, the GP is actually in no position to make judgements or insist on what should be done. I hope that when one is looking at the running of hospitals, there will always be the idea that a very senior consultant, perhaps even nearing retirement, could bring the various consultants together and, together with the patient, make sensible decisions.
	I am of course delighted to see the end of targets, which so distorted clinical management and had an appalling effect. I hope that I can have the encouragement of the Minister to say that they will go completely. However, I see a case for them if they are done at very local level by the people intimately involved-say, a GP's practice or an individual hospital-where they can see what they need to do and can set their own local target. That is the only place where I could see some sort of role for targets, and they could be useful.
	When we come to outcomes-in my terrible lay man's language, that means that you either kill the patient, cure the patient or something in between-I hope that the Government will be careful not to fall into the trap of the targets and have outcome measurements that do not actually fit the bill. It is an extraordinarily difficult thing to do and I hope that great care will be taken. That said, though, I welcome the White Paper and the Government's intentions.

Lord Turnberg: My Lords, I have no problem in endorsing the principles described in the White Paper-patients at the centre, devolving responsibility and so on-but they sound rather familiar. There seems to be a close resemblance to the aspirations that came out of the many NHS White Papers and Bills that we have seen in this House over the past few years. I have watched these come and go, as someone who worked for many years as a consultant in the NHS and as a past president of the Royal College of Physicians. The question, as always, is how to implement these fine ideas.
	I shall focus on the proposal to change the PCTs to GP consortia. If this sounds familiar, just remember GP fund-holding; the new proposals sound only subtly different. So, if fund-holding and PCTs failed, why should GP consortia work? Success always depended on the enthusiasm and skills of GPs, and unfortunately these are not evenly spread. GP commissioners have to assimilate large amounts of data about their patient populations and their diseases, know about financial and risk management and have statistical skills and an ability to develop contracts-and none of that can be done between seeing patients or after the evening surgery. Little wonder that few have expressed any enthusiasm to take on these responsibilities in the past, nor have they now. GPs will certainly need help. That can come only from re-employing either experienced staff made redundant when the PCTs are disbanded or those from the private sector, who are unlikely to be in the game for charity.
	We know that PCTs are not uniformly good at their job; some are excellent while others are less so. The reason is that there just are not enough of the skills needed to go around all 160 of them. If we have a similar, or greater, number of GP commissioners, we will run into the same problems. All this points to a need to keep the numbers small-I reckon no more than 20 or 30. That would allow a small cohort of committed GPs to work with a few experienced managers. The projected cuts in management of 45 per cent just endorse the need to keep the numbers small. What ideas do the Government have about the number of GP commissioners that they envisage?
	The numbers are not the only problem, though. The system seems designed to divide primary and secondary care still further. We can talk glibly of "seamless care" between hospital and community, but there are many ways in which these need to be co-ordinated. Indeed, any complicated disease-one has to think only of geriatrics, mental illness, stroke and so on-requires hospital specialists and GPs to work closely together in designing packages of care. It is vital for commissioning bodies to have the direct involvement of specialists in developing contracts for what should be integrated care. What efforts will be made to ensure this vital close collaboration in a competitive climate?
	Then there is the question of commissioning for education and training and for research. I have many concerns that, as these are devolved to the local level, they will be lost in the hurly-burly of commissioning for efficient and economical care in the face of savings targets of £20 billion. There is little evidence that GPs will pay more than lip service to the aspiration in the White Paper to "embed research" in the NHS. A recent survey showed that GPs were antipathetic to their being involved in research using patient data, and were unhappy with the extra work involved in obtaining consent from their patients. When key commissioners are so uninterested, it does not bode well for the future of research or teaching in the NHS.
	I do not want to say much about the involvement of the private sector in commissioning, save that it is quite unclear what incentives they will have to encourage education, training and research. How will the Government ensure that they will not be damaged in the change to the new arrangements?

Lord McColl of Dulwich: My Lords, I, too, thank the noble Lord for introducing this important debate, especially as it emphasises the importance of the individual taking charge of his or her own health. This is crucial, as the present obesity epidemic will kill millions, and half the population will be obese within 20 years.
	There has been a great emphasis on exercise as the answer to obesity and, indeed, exercise is very important in maintaining our health. Muscular activity is good for the muscles themselves, good for our bones and good for the heart. It promotes optimal levels of cholesterol, enhances morale and gives us a sense of proportion. Of the calories we consume, 75 per cent are burnt up by the organs of the body such as heart, liver, kidneys, brain, pancreas and so on, but we have no control over that. We can control muscular activity but, unfortunately, muscular activity consumes only 25 per cent of the calories we eat and drink. If we wish to take off a pound of weight through exercise, we have to run a mile. The problem for obese people is that it is difficult for them to exercise. The answer to the obesity epidemic lies in diet. What and how much we eat have a far greater impact than exercise.
	It has been assumed that inactivity leads to obesity but it is quite likely that it is the obesity that results in inactivity. Professor Terence Wilkin has been following the same cohort of children over 11 years. He found that, at least in children, inactivity does not lead to fatness, while fatness does lead to inactivity. It is very unfortunate that politicians have been misled by NICE into believing that our weight is determined by a balance between exercise and what we eat. It is simply not true. It gives the false impression that exercise and what we eat are equal contributors to body weight, whereas the evidence proves that what we eat has a far greater influence on our weight than exercise.
	Clearly, there are many contributory factors leading to obesity, such as genetic background, thyroid failure, big bones, fluid retention, psychological factors, sexual abuse and so on. However, at the end of the day we are what we eat. I was brought up in the war when food rationing meant there were no obese people apart from those on the black market. At the beginning of the war, one third of the people were either underfed or fed on the wrong food. Rationing cured that almost overnight. It was the greatest and most successful public health experiment of all time.
	What can the Government do to reduce the death rates from obesity and protect the NHS from being overwhelmed by the increasing deluge of patients with diseases resulting from obesity? The first thing that would help would be for the Government to tell their members to start giving a clear signal to the public that the real answer to obesity is to reduce the quantity of food they eat to healthy levels. The second thing is to point out that, although exercise is good for the heart and ideal cholesterol levels, it plays a small part-25 per cent-in dealing with obesity. This would reassure the army of obese people that they can take control of the situation by eating less, and then beginning to take reasonable exercise when their bodies have reached a manageable size. Thirdly, the Government could encourage the food industry to increase traffic light indicators on food it sells in order to reduce the amount of junk food. The fourth thing is a much greater drive in schools, ensuring that children and young people understand that eating sensibly will stop them dying at an early age.
	The government action against smoking was very successful, but the death rate from the obesity epidemic will prove much greater than that from smoking. Time is running out. Will the Government act now?

Baroness Armstrong of Hill Top: My Lords, I rise with some trepidation, following that. I congratulate the noble Lord opposite on this debate. I declare an interest. I have only just become a member of the board of County Durham and Darlington Foundation Trust as a non-executive. I claim no knowledge or benefit from that for this debate, however.
	I have been delighted to see that the Government-and the Conservative Party, before the election-have really discovered how much the National Health Service is valued by the British people. We have that to thank for their commitment to the National Health Service during the election, and to ring-fencing the money for it. However, as we are now discovering, that ring-fencing has lots of problems within it. The rounding-up of figures, which all Governments do, means that the annual increase will be 0.1 per cent. In fact, it is a little less than that, but that is the rounded-up figure. We all know that that will give the National Health Service incredible challenges. I want to ask the Minister some questions arising from that settlement and the ideas in the White Paper.
	The financial challenge is significant. What does the Minister think the number of redundancies within the National Health Service will be this year and next? How will those redundancies be funded? There are rumours that the funding for redundancies will come from some of the money put into the service to control demand-for example, in accident and emergency, by encouraging more people to be referred, and refer themselves, to urgent care centres. However, there are also rumours that some funding may come from budgets that are about trying to get healthcare to the most vulnerable, such as the homeless, who are frequently not on a GP's list.
	I know that many Members welcome the abolition of targets. I am amused to hear them now called "objectives", but that is another matter; I am determined not to be cynical. When I was a directly elected Member of Parliament the main concern expressed to me by constituents about the National Health Service was, "I have been to see the doctor and been told that I can have the operation in about 18 months to two years. I could go next week if I was private", with all the horror, anger and shame of that. That has not happened over the past five years. How many NHS patients does the Minister think will be waiting six months for orthopaedic surgery in February 2012? Does he think it will be 10, 100 or 1,000? I know that Ministers think carefully before they make any decisions. The decision to abolish the targets means that the Government must have estimated what effect that will have. I want them to share that thinking with us.
	Inevitably, the change to the regime that the Minister envisages in the White Paper clearly means that some NHS hospitals will fail. How many does the Minister think will have failed by April 2013?
	Finally, on parliamentary accountability, the Government are going to create the largest quango we have known in this country. That will take it outside direct questioning by Parliament. How is Parliament going to hold to account the decisions and actions of the NHS when, in fact, the money will be spent by the largest quango, the commissioning board? Who will appoint the chair? Can the Minister assure us, now that the appointments commission is to be abolished, that it will be an impartial appointment? Will it be done before the appointments commission is abolished?

Baroness Hussein-Ece: My Lords, I, too, will focus on what we mean by patient-led healthcare, which others have mentioned before me. In November 2005 a best-practice document called Now I Feel Tall: What a Patient-Led NHS Feels Likewas published. It said:
	"I strongly encourage all NHS organisations to take a close look at how they deliver their services and to ask their patients if their emotional needs are being met as well as their physical ones".
	It goes through what patients should look for. This includes,
	"getting good treatment in a comfortable, caring and safe environment, delivered in a calm and reassuring way ... having information to make choices, to feel confident and feel in control ... being talked to and listened to as an equal; and ... being treated with honesty, respect and dignity".
	The core and developmental standards for the NHS were set out in seven domains, the fourth of which is patient focus. It says:
	"Health care is provided in partnership with patients, their carers and relatives, respecting their diverse needs, preferences and choices, and in partnership with other organisations ... whose services impact on patient well-being".
	It therefore requires,
	"healthcare organisations to have systems in place to make sure that staff treat patients, their relatives and carers with dignity and respect".
	Healthcare organisations must monitor their performance with regard to treating patients and carers with dignity and respect. The evidence has always been clear that if the NHS listens to what patients are saying, it can result in new ideas, better value for money and better care. How do you measure targets in an area such as patients being treated with dignity and respect, and being listened to, when trusts will point to the often relatively low number of complaints as a measure?
	There have been numerous inquiries and other pieces of legislation setting out how to empower both individuals and communities in shaping health and social care services. Since community health councils were abolished in 2003-a great mistake in my view, and I declare an interest as I previously worked as the chief officer of a community health council-we have seen numerous attempts to make the NHS more meaningful and accountable. The establishment of local government overview and scrutiny committees with new duties went a long way to bringing accountability to healthcare services and in my view, as a previous chair of an overview and scrutiny committee, shone a welcome light into areas of healthcare services that had not previously been scrutinised. It brought about the need for greater partnership and collaborative working between local government and health. However, again, it relied on local PCTs and other healthcare trusts welcoming and being open to this scrutiny and accountability.
	I welcome the Government's plans to create local government health and well-being boards, but there have been problems on the ground in the way local government and the NHS have to work to bring about greater public and patient involvement in the NHS. In my own area, the local PCT last year took the decision to close a much loved and important health centre, in the most deprived part of the borough-the Finsbury Health Centre. The health and well-being committee scrutinised this decision in some detail and at considerable length, hearing evidence from patients, the public and clinicians. Eventually, after careful consideration, it presented its findings to the PCT, which fairly quickly rejected them. It found itself at loggerheads with the whole health and well-being committee, the council and the overview and scrutiny committee. It did not allow, for example, the chair of the committee to address or present its findings to the PCT board. As a result, the relationship between elected councillors and an unelected board of rather anonymous people, led by the chief executive, who had no accountability to the public, suffered. So, too, did local community confidence in the PCT.
	People increasingly want to be able to exercise choice and control over their care. To do this it is clear that people must have the right to reliable information to help them make choices. Things have improved dramatically in some areas over recent years but what has not improved is the consistency across the NHS. My family's experience of the NHS has been patchy. Three years ago my father spent seven weeks in hospital, suffering from terminal cancer. I saw at first hand how this 87 year-old man was gradually stripped of his dignity. While some of the nursing staff were enormously professional and provided excellent healthcare, others did not. He was not treated with the respect and dignity he should have expected. He was left in pain, with bed sores, little personal care, and alone on the floor after a fall in his room. This was a proud man, who would not leave the house without a shirt and tie, reduced to tears of humiliation just days before he sadly died. After my father's death, I decided to complain formally about the senior member of nursing staff who had been so unprofessional to my father and my family. I was perhaps not surprised to learn that there had been a number of complaints about this individual, but none had been taken very far, due to the sheer difficulty, time and bureaucracy involved. This is not an easy time for families and carers.
	I welcome the fact that patients will have more choice in terms of their GP. I hope the reforms will underpin not only greater choice but more consistency across healthcare services, so that people like my father have a better experience of the NHS.

Baroness Northover: I remind noble Lords that this is a time-limited debate. There is another important debate following ours. We need to give noble Lords in that debate the courtesy of being able to start and finish on time. I remind people that when the clock reaches four minutes, noble Lords have spoken for four minutes. There is also somebody who wants to speak in the gap.

Lord Rea: My Lords, I will use my four-minute slot to talk about the role of health professionals-one of the aspects mentioned in the noble Lord's Motion. I am a former cog in the NHS machine, so I have some knowledge of working there. When my noble friend Lord Darzi spoke of increasing the involvement of clinicians in NHS decision-making about three years ago, he was thinking of drawing on their experience of the realities of front-line medicine and surgery. Now what is proposed is the greater involvement, especially of GPs, in the complex process of commissioning care. This requires many skills which are outside the training and interest of the majority of practising doctors. It is true that many PCTs are not up to speed and we have heard that some of them are remote.
	The final report of the Health Committee of the previous Government said that PCTs,
	"employ large numbers of staff, but",
	too many are not of the required calibre. It went on to say that PCTs need to become, "better at collecting data"-for example, on the needs of their population-and at analysing them. That is not a very flattering remark, but are these weaknesses enough to justify closing down all PCTs and replacing them with GP-led consortia, with all the upheaval and chaos-not to mention expense-which is caused by such a major reorganisation? I think not, because the skills in which the Select Committee found PCTs to be weak are not skills possessed by the average practising GP, whose training lies in assessing and treating the health problems of individual patients and families.
	Of course, some have developed a wider outlook and are interested in public health and preventive medicine, and some have considerable entrepreneurial skills, as the department knows well, but these are a minority. The expertise needed properly to commission healthcare for a given area includes an ability to assess the health needs of whole populations, not simply those on GP practice lists, as well as managerial and planning skills-the very skills which the Select Committee found wanting in many PCTs. GP consortia are likely to have the same or greater shortcomings, even if they re-employ all the most expert staff now working for PCTs because of the disruption of working relationships which will follow the abolition of the PCTs. Also, staff with these skills are those whom the newly empowered directors of public health-which, with provisos, I greatly welcome-working with local authorities, will require to assist them in their enhanced new role in local government, so there will be competition for staff with the appropriate training and expertise.
	As the noble Lord, Lord Hunt, said, independent consultants and healthcare firms are waiting to step in to fill the breach-at a price, of course. Sometimes one wonders whether this was the main purpose of the whole exercise. Perhaps it is too much to hope that the Government might think again considering the very hostile reception that this proposal has received from nearly all health professionals and health think tanks, including the King's Fund. In the final seconds of my speech, may I ask the noble Earl whether he can assure us that the newly empowered directors of public health, who will be working with local councils, will be fully funded, that this funding will be protected and that they will also have a statutory role in their work with local government?

Baroness Wall of New Barnet: My Lords, I also thank the noble Lord, Lord Hunt of Wirral, for giving us the opportunity to debate this subject. The contributors to the debate will know just how important it is to everybody. I declare an interest as the chair of Barnet and Chase Farm Hospitals NHS Trust, an acute trust delivering general and highly specialised healthcare to a large area of north London.
	The policies of any Government have a direct and profound effect on the quality and outcomes of patient care. For some time our trust motto has been, "Patients First and Foremost". Our staff work towards this vision at every stage of their careers and throughout all government policies regardless of the party, or parties, in charge. That is why I have paid great attention to the Government's policy on patient-led healthcare.
	Much progress has been made on the timeliness of services within the NHS through the target-driven process initiated by the previous Administration-my Government. The present Government's moves to dismantle this structure must not be allowed to lead to the loss of these crucial improvements, but rather build on them. However, the time may be right to move from the assessment of service quality by time, which was an imperative at the point these processes were introduced, to combine this with the more clinically sensitive indicator of outcomes. I feel that it is a pointer to the success of the previous Administration in upholding the original vision of the founders of the NHS that we are now able to consider such a transition. Within my own trust great strides have already been made in many areas, particularly with the reorganisation of the A&E services and acute medicine, leading to shorter waiting times and a better service for our patients. Future progress in these areas may be better measured by combining quality of outcome rather than timing alone, important as this has been in increasing our standards to the present levels.
	In other areas such as modern cancer services, which received a massive investment under the previous Administration, the question of timeliness of care has again largely been addressed. Perhaps we should move to realising the benefits in terms of quality and outcome measures made possible by previous investment. However, I caution that we should do this without taking our eye off the ball as regards acknowledging the importance of timely action for those diagnosed with or suspected of having cancer of any kind-for those people, time is of the essence. In my trust, great changes have taken place in providing local, modern, advanced cancer services, with the use of laparoscopic and robotic techniques. It is important that this is maintained and monitored against the highest national and international standards.
	Many patients served by my trust are elderly. We must recognise the demographic changes, as other noble Lords have said. The country as a whole must think about this in the design of its services. For this enlarging sector of our population, true quality of service demands not only timeliness and excellent outcome but an additional vital ingredient: local provision. Some services that my trust provides are excellent by national standards, and the outcomes are very important. We must not in any way threaten them by an ill thought-through, centralised agenda. The knock-on effect of removing these local services will, if allowed to progress, threaten to undermine excellence in other areas that they support. The White Paper says exactly the opposite of this. Localism is really important. I ask the noble Earl for that confirmation today. Localism is important: people know what is important to them locally. I am sure that the noble Earl, who is smiling at me, understands that from the recent visit that he made to my trust.
	I finish by saying that the role of front-line health professionals is paramount in ensuring that the delivery of this White Paper, and more importantly of health services overall, is recognised by patients. The implementation of government policy is a weight that they carry. It must not become such that it interferes with the delivery of services. Make no mistake: we are being watched by everybody. As a trust, we think that it is very important that we are able to step up to the plate, as the saying goes.

Lord Naseby: My Lords, the coalition Government's strategy for the NHS is clear and very welcome. The first stage is the White Paper, consultation on which has just been completed. The responses were of a good volume. Three objectives were outlined in the White Paper: the one that we are discussing today, creating a patient-led NHS; improving healthcare outcomes; and increasing autonomy and accountability in the NHS. We also know from the comprehensive spending review that the funding is ring-fenced and is available only for the NHS.
	Frankly, I sat in blank amazement listening to the noble Lord, Lord Winston, claim that at the general election the NHS was in its healthiest state for decades. I remind him that we were left with mixed wards, which we were told 13 years ago would be got rid of. We had the chaos of out-of-hours cover. I do not need to remind the noble Baroness on the Front Bench of a number of tragic cases. We had a situation where a number of brought-in, standby, out-of-hours doctors did not even speak English. We have had questionable care on the nursing front. I support what the noble Baroness said earlier. My wife is a retired GP and is pretty objective when it comes to nursing care. I am sorry to report that nursing care at Papworth is certainly not world-class. Frankly, it is pretty poor. We have a situation where cancer drugs have not been sorted out for the past 13 years. I make a plea to my noble friend on the Front Bench. If we have £200 million of ring-fenced money for cancer drugs, although it is to be deputed to the existing regional health authorities, can we not consult with cancer charities on which drugs they think would be a primary help in that particular budget? Perhaps I do not even have to mention IT and the billions that were spent on something that has not worked. Do not tell this Government that the NHS was left in the best state ever after the past 13 years.
	I look back to a time when my wife was a second-phase GP fundholder. Most GPs were in the fundholding scheme: only a hard core were not. That was successful; it worked. It is no good the noble Lord shaking his head. GPs who went into fundholding achieved very short lists for operations. The scheme worked well and I am sorry to say that it was only through prejudice that the incoming Government got rid of GP fundholding and then produced modified targets that they thought were a substitute for it. They were not.
	I will finish by saying a couple of words about medicines. Traditionally, medicines in the NHS have taken up between 10 and 12 per cent of the budget. I have noticed two worrying developments. First, the standard of generic substitutes is not what it should be. We have seen the recent case of Lipitor, and a number of other cases are documented in the pharmaceutical area. Something must be done about that situation. The second is counterfeit medicines, which I do not think were a problem 13 years ago. Again, I am not blaming the outgoing Government for this but there is now a problem across Europe with counterfeit medicines, and I shall mention two statistics. First, 62 per cent of medicines bought on the internet are counterfeit or substandard and, secondly, across the whole of Europe in 2006 no less than 2.7 million fake medicines were seized. I do not wish to say any more, other than that I look forward to receiving answers to the questions that I have raised.

Baroness Donaghy: My Lords, until last year I was a non-executive director at a foundation trust hospital, and I am an independent assessor for clinical excellence awards at both local and national levels. Therefore, to that extent, I declare an interest.
	My views are of course influenced by personal experience. I remember what the National Health Service was like before the Labour Government were elected in 1997. It was coming up for air for the second time. It was starved of resources, innovation and decent buildings. However fashionable it may be to condemn target cultures and so-called spending sprees, the Labour Government tried to catch up on a generation of neglect. Waiting lists were the scandal of the day, with demoralised and underpaid staff and a Nissen-hut building culture. Some of us will never forget that and will for ever be proud of what Labour tried to achieve. However, it was always going to take a generation to succeed and unfortunately we did not have that amount of time.
	I always assumed, perhaps naively, that a coalition Government were about strategic consensus but I just wonder whether this coalition Government are not about mixed messages. They claim to support localism but set up the biggest quango in the world, doling out £80 billion. It does not get much more centralist than that. The NHS Commissioning Board will also be taking on responsibility for specialist commissioning and at least 10 other important roles. It is going to be accountable to the Secretary of State for financial stability, and, yes, it is going to be independent of the Government? If it looks like a quango and acts like a quango, surely it is a quango. In order to carry out these functions, the commissioning board will require an enormous framework to build intelligence and process information. Will it have regional offices, provided they are not called SHAs? How will this leviathan work?
	Then we come to the proposals for Monitor's new role. I have had direct experience of Monitor. I joined the board of a London hospital which had just been turned down for foundation trust status and we worked hard to achieve it the following year. Monitor's job was, as the consultative document says, to authorise foundation trusts. If applicants for foundation trust status were not up to the stringent requirements of financial planning, sustainability, governance and leadership, they did not obtain that status. The new role envisaged for Monitor is to develop a general licence for all. Does that mean that it will lower its standards? It will certainly be a completely different body with completely different skill sets, and it will require considerably more staff to undertake the responsibilities envisaged.
	Finally, within three years it is proposed to support all NHS trusts in becoming foundation trusts. It will not be an option for organisations to decide to remain as NHS trusts; they must become, or be part of, a foundation trust. Will NHS trusts still have to meet the current tough requirements in order to become FTs or will there be a lower levelling? Will those who have no hope of achieving FT status due to a long-term lack of financial viability be foisted on existing FTs, deficits and all, leading to a lowering of standards? The consultative document claims that the debate on health should no longer be about structures and processes. However, the Government's proposals are precisely about structures and processes, and promise to be an enormous waste of badly needed resources.

Baroness Knight of Collingtree: My Lords, we need to retrieve the excellent reputation which Britain once had in the healthcare stakes. Not long ago, we were the envy of the world in those stakes but we are not today. Recently, I read a list of figures which showed how far we had slipped back in survival rates, standards of care and so forth. We used to be top and we are now sixth, seventh or even lower. This Government are resolved to do better and, even in the truly desperate financial state in which the previous Government left us, they are safeguarding the NHS budget. I think the figures are a little better than stated earlier by the noble Baroness.
	British people love the health service and gladly support it with their taxes, but they expect to get value for their money and a good standard of healthcare when they need it. In thousands of cases, the previous Government failed them. A system grew up in which the individual patient did not matter. The most significant and important of all the new aims is that every patient will matter. You can have brilliant accountants, business experts and superb organisers running the health service, but if the welfare of patients is not a top priority, you will not have a worthwhile service.
	In recent years I have raised scores of cases where patients have been treated extremely badly in hospitals and most died. Not once did any of those patients receive an apology and many of the cases I put forward were not investigated at all. The only response I ever received from hospital trusts was outrage that I should have had the barefaced cheek to criticise them at all. What on earth did mere patients matter? I am mightily relieved that this is to change. If the noble Lord, Lord Winston, thinks that there has been just one tiny case of bad treatment of patients since this Government took over, I will gladly give him my files of the other cases I have mentioned.
	I am very relieved that this is to change because it seems to me that doctors and surgeons still sometimes retain their status as being one step down from the Almighty. I absolve every Member of this House from behaving anything like that, but some still do. Of course they are wonderful people and they are true saviours in many cases, but they should not treat patients as inanimate, deaf and blind objects to be discussed as if they were not there. I hope that we shall reach a situation where patients are addressed correctly and not by their Christian names, unless they have asked to be so addressed and they should not be questioned about it. I hope that they will not be put in mixed wards, unless it is an intensive care ward. I also hope that cases such as my noble friend Lady Masham brought forward will mean that we shall have switches that cannot be switched off unless there is clearly someone to turn them on again or switches that will not go off. I ask my noble friend if these vital improvements might perhaps be achieved in less than three or four years, as the report indicates. We need them so much.

Viscount Simon: My Lords, it is interesting that numerous professional societies which deal with chronic illness have concerns about potential inequalities of commissioning, the lack of involvement of specialists in commissioning and the potential fragmentation of services that an expansion of the internal market would generate. However, I have been made aware by the British Thoracic Society of its separate anxiety, which relates to the apparent lack of prioritisation for patients with long-term lung disease. The previous Government, at the instigation of the chief medical officer and the Department of Health, spent four years developing a national strategy for COPD and asthma that went out to public consultation earlier this year. The accompanying economic impact assessment made it absolutely clear that good-quality, integrated, community care for people with COPD would improve care and save about £1 billion over 10 years.
	There is no mention of this in the White Paper, and there is general concern that it has been dropped on ideological grounds. The assessment of services on markers of quality is admirable where it exists, but it is likely to focus on what can be easily measured, such as cancer rates, heart disease, et cetera, not on what needs to be measured-such as the impact of chronic lung disease. I should declare that I have severe allergic brittle asthma and can get very ill within a few seconds, and that I was a member of the Select Committee considering the provision of allergy services.
	The European Union, under the Belgian presidency, has adopted chronic respiratory disease as one of two priorities presented to the Council of Ministers in Brussels last week. It would be a shame if England were not to promote recommendations for improvement in costs and quality of care by integrated working. Numerous societies would like the national strategy to be implemented, and I hope that the noble Earl will be able to address that concern.
	I am aware that there is a new allergy clinic in the Midlands, but there are still insufficient trained allergists for the demand throughout the country. Patients with allergic conditions are sometimes given inappropriate treatment by other, non-allergy-trained doctors. I hope that the noble Earl will also address that concern without delay.

Lord Mawson: My Lords, I want to make a few points about health and social care. How do we provide quality healthcare that meets the real needs of patients in today's world? Will the popular biomedical model of health meet all those patient needs, or does its internal logic present us with a limited view of what a human being is and provide us with an expensive approach to healthcare? Is what we say that we believe about health believable?
	My Lords, the GPs I work with in east London tell me that in poor communities such as Tower Hamlets, 50 per cent of the patients they see do not actually need a doctor; they need something else. What presents itself as illness may actually be more to do with a patient's isolation, the need for a friend or a job, better housing or a more creative lifestyle. In such cases, attempts to find a magic pill or potion are inappropriate and a waste of resources; GPs and patients need our help.
	In this new financial environment, there is an opportunity to begin to open up a more integrated and cost-effective approach to healthcare at a national level which builds partnerships between health and social care professionals and with the voluntary and social enterprise sectors, but it will require encouragement and leadership from within government if this more integrated and cost-effective approach is to work.
	GP practices are anchors in local communities that could play an important role in the development of the big society. Four years ago, I was asked to intervene by the then CEO of the local authority in St Paul's Way in Tower Hamlets, which is a single street in one of our most challenged housing estates. I am now leading the St Paul's Way transformational project, so I declare an interest in this project, but I am pleased to say that it is fast becoming a pathfinder used to illustrate the benefits of joined-up working. We are now exploring the possibility of creating a community interest company, which in time may manage the facilities along the whole street. When I first arrived on the street, I was shocked to discover that there was the possibility of developing a new £40-million school under the BSF programme, a new health centre across the road and 500 new homes. So what was wrong? None of the key players in health, housing or education were talking to each other.
	The new focus on patient-led healthcare could result in new relationships between doctors and health professionals and local members of the voluntary and social sectors. This more integrated approach is important because, at present, strategy is running on departmental lines. Education is introducing free schools, health is devolving budgets to GPs and social services are extending personalisation budgets. Society does not operate along departmental budgets. Go to any town or city district and ask the police for the top 100 families that they routinely deal with for anti-social behaviour. Ask the GPs who are their most demanding patients; ask the housing office and the courts. The same names will keep appearing. Despite decades of rhetoric, the same tragic newspaper headlines will keep appearing-baby Peter being one horrifying example.
	Unlike the initiatives of the previous Government where the state was encouraged to be joined up, my colleagues and I would suggest that the state will never be joined up and that the answer is to let communities and local organisations, such as GP practices, join up on local streets to deliver joined-up services. I am encouraged that this is the direction that the Government seem to be taking us. We must take the opportunities that this presents. I suggest that in this financially strapped environment there is a new opportunity to turn this old health logic on its head. But the Minister will ask how we are going to do this and how we will we create the physical environments on the ground within which this can take place.
	One answer is already there; namely, LIFT, the Local Improvement Finance Trust. We could do a great deal with this, but there is not time to go into the detail. I leave the Minister with one question: will he tell the House how he proposes to encourage GPs to take up the opportunities presented by the transfer of funding to GP practices? What is the Government's plan for general practice to play in the creation of the big society?

Baroness Gould of Potternewton: My Lords, I will concentrate my remarks on public health, particularly sexual health, on which I have spoken so often in this Chamber. It is clear that the White Paper does not understand current provision for sexual health, to which I shall return in a moment. First, I should declare an interest as chair-I still am for another few weeks-of the Independent Advisory Group on Sexual Health and HIV. I am encouraged that sexual health is still on the agenda, with a new committee being established. I hope that the committee will have the capacity to ensure that sexual health and HIV does not go back to the days of being the Cinderella service that it was under the last Conservative Government.
	The introduction of a public health service, incorporating all aspects of sexual health, could provide the opportunity to commission improved and holistic sexual health and HIV services, and to join those up with other allied public health services. But, as my noble friend said, local government will be taking on this responsibility with no experience in the field whatever. There has to be clarity as to who will be responsible for commissioning sexual health and HIV services.
	I am not in any way opposing the concept of patient choice and I am pleased that it will cover aspects of long-term care. But there is a uniqueness about sexual health, for health promotion and healthcare have been and should continue to be clearly linked. To maintain that link, overlapping frameworks for health, public health and social care are essential, which has been achieved in the sexual health field by community clinics. Where do community clinics for STIs and contraception fit into the new structure, because there is no mention of them? Has an impact assessment been undertaken to identify their value? They have provided a model of patient choice from a range of providers. That model is now threatened by the shift to GP commissioning. Considering that few GPs want to take on this work, I have to ask whether the community clinics will continue and whether the GP consortium will commission them to do the work.
	A matter of great concern is education and training, which will now be the responsibility of providers. An enormous knowledge gap has to be filled by GPs, nurses, and local authority staff. Who will determine the level of training required?' Who will pay for it? Who will determine the level of standardisation and accreditation that is required? A lack of experience among GPs and local government means that it is unlikely that they will be able to commission effectively.
	Many patients want support and advice to make sense of their options. It is therefore essential that all patients have confidence and trust in the choices being offered, which means a workforce that is properly trained and skilled. With the abolition of the PCTs and SHAs, this will be further exacerbated because many staff are already leaving the service. That loss of trained personnel will seriously affect the whole question of how much training will be needed. Patient choice and quality of service is already being diminished by closures of services in public health and in some hospitals. For instance, one consultation document produced by the Government talks about choice for those who are dying. At the same time, I am aware of at least one special NHS unit to ease dying for the patient and their families that has been closed down. Those people are not being given a choice and their objections are not being listened to. There are cuts in the provision of chlamydia screening, with clinics closing and reductions in contraceptive services. These front-line services are easy options for cuts which will deny the patient not only choice but access to services.
	Many issues arising from the White Paper still have to be resolved, but how do we convert rhetoric into reality? At the moment we have fine words but we need much more than that: we need absolute detail.

Baroness Miller of Hendon: My involvement with the National Health Service is that five years before I joined your Lordships' House I was the chairman of a local family health service authority in Barnet. I was responsible there for overseeing what went on in the general practices, working with National Health Service doctors and dentists and with pharmacies. We initiated a new scheme in the pharmacies called High Street Health. This scheme spread around the country, but was started in Barnet.
	I was also for some four years the chairman of the national league of hospital and community friends. The branches of hospital friends consist of those tireless volunteers who work in our National Health Service hospitals, providing all kinds of patient services and comfort, running news stands, and raising money for patient amenities and even sometimes for much needed equipment. In other words, they were acting as the big society more than 60 years ago, although we now hear so much about it being a new idea.
	From my contact with the dedicated workers in the friends organisations and in my work in a local health authority, I have knowledge of what patients and users want. Of course, I do not have medical knowledge; mine comes from a completely different angle. The White Paper, which I think is an excellent consultation, talks a lot about outcomes but I can tell the Government what outcomes patients want. First, they want to get better; as part of the process of getting better, they want a GP who knows them personally, with the kind of friendship that I and my family have been lucky enough to have with our local doctor. If they go into hospital, they want it to be clean and germ free so that they are not in danger of coming out in a worse condition than when they went in. As has been mentioned by others, they want an end, once and for all-and without delay-to the scandal of mixed wards. Numerous Health Secretaries on both sides-I am not accusing any one Government of this-have promised it but it has not been delivered. There is no excuse for this third-world arrangement. It is not appropriate; it is an inexcusable penny-saving matter.
	Another outcome that patients want is that the National Health Service will provide medication when they need it. They do not want to find that treatments are available in some parts of the UK but not in other parts, or that they are denied to United Kingdom residents but are freely available on the continent.
	The training of future doctors is a matter of equal concern. Without being in any way chauvinistic, the public want fluent English-speaking doctors. The working time directive, which limits the hours that poor young trainee doctors are able to work, is having an adverse effect on their ability to gain the skills they need to become specialists themselves.
	I regret to say that the National Health Service has been a political football between the parties for far too long. It should stop. No party has done exactly as much as it should. Let us hope that this consultation will provide what is needed for this, as my noble friend said, patient-centred and led health service.

Lord Beecham: My Lords, the noble Lord, Lord Hunt, and I last had a brief encounter about 25 years ago when he chaired the inner-city partnership in Newcastle and I was the leader of the city council. I cannot say that that brief encounter leads me to the noble Lord's Motion in a blithe spirit, but I shall begin as I do not mean to go on by welcoming at least some of the proposals in the White Paper, particularly the return of public health to local government, whence it was removed by Sir Keith Joseph's reorganisation in 1973, and the conferment on local councils of leadership in health improvement. Both will be good examples of integrating services rather than fragmenting them, which so many of the other proposals in the White Paper will certainly do.
	The House will of course welcome the emphasis on patients and clinicians expressed in the mantra that the noble Lord reminded us of: "No decisions about me without me". It is a pity that that mantra was not applied to the development of the policy that has produced the massive changes that we are debating today.
	The White Paper and the Motion seem to imply that, until now, patients and patient care have not been central to policy, as if the record investment in hospitals, clinicians and nurses and the massive reductions in waiting lists were for the benefit of bureaucrats rather than patients. My own personal experience certainly refutes that, unlike the unfortunate experience of the noble Baroness opposite, who told us about her father. Eight weeks ago tomorrow, my wife died, two years after being diagnosed with cancer. She was a health visitor and nurse, but worked with GPs on training. We had nothing but praise and gratitude for the care that she received in a state-of-the-art cancer unit opened just 18 months ago. She was the daughter and sister of doctors and she would want me to say that she entertained grave doubts as to the proposal to go wholesale into GP commissioning, doubts that are shared by the BMA and many others.
	It seems extraordinary that GPs are to be conscripted into consortia, whether they like it or not, with no evidence of their capacity to commission and no assurance of coterminosity with the local authority services with which they must surely connect. Perhaps the Minister will indicate how many GP consortia we are to expect-we have heard figures varying from 630 to 80-and how the consortia might be expected to work with appropriate local authorities. In any event, there is a significant shift to nationalising a whole range of commissioning services, including mental health, maternity, dentistry, ophthalmology and pharmacy-so Barnet would not have been able to do its own pharmacy commissioning under these schemes-which will fragment the key relationship with local councils. Commissioning should be local, involve councils and be piloted.
	In addition, it is clear that accountability will be weakened as local government scrutiny powers are watered down. A national board will oversee GPs; health and well-being boards with little local government representation will, in effect, scrutinise themselves; an increasing number of hospitals are to be dragooned into foundation status; and, with the concept of "any willing provider", as the BMA states, there is a significant risk of two-tier services developing, threatening value for money in the NHS.
	Much of the White Paper and the debate today is based on a presumed thirsting for choice, which in the BMA's view-I think that it is shared by many other observers-does not really exist in the form that is imagined. The BMA rightly suggests that, most of all, patients want a high-quality provider close to where they live and to receive timely, competent diagnosis and treatment. The White Paper blurs the distinction between personalisation, which is essential, and choice of provider, which is not. The BMA recognises the need for some proportionate targets.
	Support for the Secretary of State seems to be underwhelming from most professional bodies and patient organisations. We are in for a massive and expensive reorganisation, which has been determined with consultation restricted to the detailed application and not the principles. There is no sign here of any clinical trials. The Secretary of State is guilty not merely of a rush to judgment but a rush to misjudgment, with potentially serious consequences to the NHS and the people whom it serves.

Baroness Thomas of Winchester: My Lords, with so little time for niceties or an introduction, I shall concentrate my remarks on the management of those with muscular dystrophy and therefore declare my usual interest. I know that my noble friend the Minister has in the past attended the all-party group here in the House, which has endeared him to all those working in this particular field. I wonder whether he would be prepared to meet the group again soon in his new role to discuss some of the issues that I shall mention today and some which there is no time to mention.
	Some 60,000 children and adults in England are affected by one of more than 60 different types of muscular dystrophy. These are rare or very rare conditions that weaken and waste muscles. They can cause lifelong disability and, in some cases, premature death. There are currently no cures or treatment and, without multidisciplinary care, most patients and their families experience a further reduction in the quality of life and, for some conditions, shortened life expectancy.
	The Muscular Dystrophy Campaign, in its responses to the White Paper consultations, has welcomed the proposed NHS commissioning board for specialised services and believes it to be a necessary step towards a national neuromuscular service for those with these neglected conditions. We urge the Government to make sure that the board is well enough resourced to ensure that all who need care can access it wherever they live.
	As for GP commissioning, it is clear that GPs simply do not have the knowledge, experience or patient numbers to commission services for these extremely complex and rare multisystem disorders, some of which affect just a handful of patients in the country. In addition, these are costly low-volume services, so regional commissioning is essential to share the cost among a larger population base. Currently, many people living with these conditions are denied both essential and specialised care, such as respiratory care, and non-specialised care, such as physiotherapy or hydrotherapy. It all depends where they live. The all-party group revealed in the Walton report published two years ago that this postcode lottery has had devastating consequences. Young men with Duchenne MD die on average 10 years earlier in some parts of the country than in others simply due to a lack of specialist care.
	Not only is that inconsistent access to care needlessly damaging lives and families, but it is costing the health service a huge amount of unnecessary money. It is estimated that the NHS last year spent a shocking £68 million in England on unplanned emergency hospital admissions. Clinical audit data have shown that such admissions could be greatly reduced through the provision of specialist multidisciplinary care.
	Spreading knowledge of the conditions that I have mentioned would be greatly enhanced if there were a new National Institute for Health and Clinical Excellence quality standard for Duchenne muscular dystrophy based on the internationally agreed standards for care published by TREAT-NMD in the Lancet Neurology, a course of action that I hope the Minister will endorse.

Viscount Bridgeman: My Lords, I, too, thank my noble friend Lord Hunt for initiating this debate and I declare an interest as a former chairman of an independent hospital.
	In the brief time available to me, I want to speak about overseas health professionals, particularly nurses practising in the United Kingdom. I hope that this matter will be covered in greater detail in a debate for which I have my name down and which is working its way up the list. As your Lordships will be aware, nurses coming from within the European Union have the right under the recognition of professional qualifications directive to practise in the United Kingdom subject only to producing evidence of technical competence obtained from their country of origin. The relevant directive specifically prohibits blanket language testing by the Nursing and Midwifery Council as a condition of registration.
	The current immigration problems faced by this and previous Governments mean that, inevitably, recruitment of skilled personnel from outwith the European Union is severely restricted. Many hospitals feel the loss of top-quality Australian, New Zealand, South African and Canadian nurses. The supply of home-trained nurses barely meets demand, so inevitably many hospitals and healthcare institutes have to rely on the only other source of nurses-the European Union.
	In some member states, particularly those in eastern Europe, there is a shortage of advanced clinical technology and it follows, therefore, a shortage of opportunities for their nurses to be trained in the use of advanced equipment. As for language testing, your Lordships will appreciate that there is a considerable difference between a working level of conversational English and the very much more technical language of, for example, the surgical theatre. There have, unfortunately, been cases of theatre nurses from the EU slipping through the language competency net. I know of one incident of a wrong instrument being handed to a surgeon in the course of an operation as a direct result of a language misunderstanding. I am in no doubt that this is not an isolated incident. I do not know whether the sad case related by the noble Baroness, Lady Masham, owed anything to a language misunderstanding but, on the safety issue, there is a disaster waiting to happen.
	The directive is in the course of being revisited. The relevant department in Brussels has been engaged in a consultation exercise with the healthcare professions in the Union, which will, one hopes, determine how the language issue may be addressed. I am reassured that the UK's Nursing and Midwifery Council was appointed to collate other members' views. I have had a helpful meeting with the Minister on this matter and am grateful for his answers to my Written Questions, from which I note that the issue of language competence is currently being discussed with the European Commission, the GMC and other organisations. I suggest that for the commissioning body, which is in the early stages of gestation, there is a good alternative in the Nursing and Midwifery Council, which is up and running and perfectly placed to undertake this language supervision.
	A resolution to this problem cannot come too soon. Patient safety must not be allowed to be prejudiced by the directive as it stands. I wish the Minister well in his efforts to address this urgent problem.

Lord Brooke of Alverthorpe: I am grateful to the noble Lord, Lord Hunt of Wirral, for promoting the debate and express my gratitude to the several professional organisations that have provided me with briefings. I make a contribution today simply as an NHS patient who has no private medical care or back-up whatever. I am also a former cancer patient; I hope that that continues to be so, but I have been waiting nearly three months for an appointment to deal with a spot on my hip. I finally managed to get one this week at the Chelsea and Westminster Hospital, where, within seven days, staff will do a local operation on it. They hope that it will not be the start of skin cancer.
	I was spitting blood the other day when I listened to the Minister defending the Government's position on cancer timetabling and how treatment was taking place. In my case, it had nothing whatever to do with commissioning or the hospital. The problem arose with what has been happening within my GP practice. I know that people in GP practices in many areas are under a great deal of stress and strain and I greatly sympathise with them, but it is extraordinarily difficult when so many patients cannot get through on the phone to their GPs and so cannot get an early appointment with a GP of their choice. They cannot get a meeting with their GP out of hours-it must be at the convenience of the doctors-and certainly cannot get GPs to come out at the weekend or at night. These are issues that my Government were responsible for; they tried to put them right and did not get them put right, so the new Government should be putting them right and not moving on into other areas.
	As far as I can ascertain from how things are moving at the moment, there will be little change on these fronts, or indeed on many other issues that have been raised on the Government's side of the House when there have been complaints. The White Paper and the programme in front of us will not address those problems. I speak with a degree of anger when I see that we are now moving into an entirely new arena, which was not forecast in the run-up to the general election. There was no debate on it and it was barely mentioned. It was not in the Conservative Party manifesto or the coalition agreement, which just said that nothing was going on. I am sorry that we do not have many Lib Dem contributions today because, in the past when we have had debates on the NHS, we have been chased all over the place by them. Today they are missing and they should be ashamed that they are not standing up and taking a firm stand on these issues.

Lord Alderdice: I am grateful to the noble Lord for giving way, but I have to point out to him that he is incorrect on almost everything that he has said in the last few minutes about those speaking from the Lib Dem Benches, as well as about the coalition agreement and the manifestos.

Lord Brooke of Alverthorpe: I shall not go into that-I shall move on. If we are faced with this, we need greater openness and transparency and greater access to the economic factors behind it all. If I was in the private sector, all the issues that I have just complained about, with a private GP looking after me, would have been solved. I would have had access to the information and to the costs. We should move to a position where, if people are given choices, they should know what the cost is. Equally, we should be given the opportunity under the changes to know what is being paid into the GP consortia, what profits they will make and what the private sector providers will get out of it. At the moment, this area is all within the public service, but it is likely to be privatised under the coming arrangements. Those are the points that I put to the Minister-there should be greater openness on the economic side of the operation.

Baroness Finlay of Llandaff: My Lords, I am grateful to you for allowing me to speak briefly in the gap.
	Since 1948, GPs have been independent contractors. GP practices belong to the partners, who increasingly employ salaried GPs rather than taking on new partners. In the consortium, they will need to employ advisers to manage their commissioning responsibility. Therefore, if the constituent practices are offered a good deal by a private company that also, for a fee, manages the commissioning, why not agree? That private company will then effectively own the consortium, do the managed care commissioning and keep the profits for its shareholders-effectively giving control of the NHS funds to private firms, many of which may be based abroad. Will patient need or commercial profit then determine healthcare contracts with local specialists? We live a seven-day society. Without a proper, patient-centred, 24/7 service, patients' needs will not be properly met. I suggest that GP consortia and employment terms need a radical rethink.

Baroness Thornton: My Lords, the Government in their White Paper propose to establish the independent NHS commissioning board, establish new local authority health and well-being boards, develop Monitor as an economic regulator, and expect to have the new commissioning system in place by April 2013, by which time SHAs and PCTs will have been abolished. The noble Lord, Lord Hunt, is perfectly right to say that this is big.
	It is a shame, therefore, that we did not have double the amount of time for this debate to enable noble Lords to develop their arguments. We still need to have those discussions about the Government's proposed reforms. These are reforms that will turn the NHS on its head if they are carried through, and bring with them considerable risks to patient care throughout the system-in transition, and possibly in the outcomes. As Philip Stephens said in the Financial Times on Tuesday:
	"NHS reform, an accident waiting to happen".
	I agree.
	The Minister will forgive me if I repeat the question that I have put to him on at least two other occasions: where is the evidence base for this revolution? The noble Earl has quoted to me international league tables, arguing that the NHS is not succeeding as well as the health services of other countries; but we can both play at that game. Indeed, I can quote a table which shows how well the NHS is doing and is at the top. I will make it my business to make it available to the noble Baroness, Lady Knight. Certainly, not one of the league tables suggests that the NHS is the kind of basket case of underachievement that the noble Lord, Lord Alderdice, suggested.
	The question that the Minister fails to address is: where is the evidence that requires the wholesale disruption of the UK health services to deliver what may well be legitimate improvements that the noble Earl and his Government seek to make? The noble Earl's failure to provide the evidence leads to only one conclusion: that the evidence to justify the wholesale disruption of the NHS does not exist, and that the Government have set their face against pilots which might provide us with the proof or otherwise that this proposal will work. Legislation could then follow the evaluation of those pilots. You may then add to this that the reorganisation was not proposed in either the Conservative or Liberal Democrat manifesto. The coalition agreement said exactly the opposite-that there would be no top-down disruption. We can only assume that this is driven from within the Conservative Party by an ideological commitment, presumably led by the Prime Minister-despite whatever he may have said during the general election.
	I have increasingly felt over the past month that Andrew Lansley and I are reading different submissions about the White Paper. I am reading them all, and I expect that he is, too. He seems to think that they are wholly positive. Everyone agrees that the Government's overall objectives of patient choice and clinical leadership are right-and most of the submissions state that. At that point, I can only think that Andrew Lansley stops paying attention, or stops reading. The reason I say that is because, with few exceptions, most of the submissions-from the most positive of the BMA, given that doctors have a great deal to gain from this not simply in terms of responsibility, to the most worried, including those of the Stroke Association or the British Thoracic Association-are all saying, "Whoa, slow down. Such a large upheaval and change needs to be properly piloted and evaluated"; or they are asking the type of questions that can lead you only to that conclusion. I am afraid that so far the Government have signally failed to provide answers to some very legitimate concerns.
	Certainly, there has been an outpouring of consultation papers from the department, and were Andrew Lansley not in such a dangerous hurry, that would be good. There would be a reasoned and sensible debate across the piece, but the breakneck timetable of Andrew Lansley means that there has to be a question mark over how seriously the Government are taking the concerns and reservations of an increasingly loud chorus.
	This puts huge responsibility on us in Parliament in both places to ensure that these voices are heard and their questions answered and that we do not allow such wholesale disruption of the UK's health services at the ideological whim of this Conservative Government. Can the Minister tell the House what is the timetable for the proposed legislation and whether there will be an opportunity for prelegislative scrutiny? That would go some way to making this process more accountable and more considered, which something of this magnitude deserves.
	If only one in four doctors believe that the proposed reforms will improve the quality of the patient care and only 22 per cent of doctors believe that the NHS will be able to maintain its focus on increasing efficiency while implementing the proposed reforms-which is what the King's Fund says-will the Government please heed the chorus which says slow down? This is £80 billion pounds of taxpayers' money. This is too big without more thought and explanation. This needs to be properly tested and piloted. This is people's lives and well-being. Surely we all deserve time and consideration for something so big.

Earl Howe: My Lords, this has been an extremely wide-ranging and well informed debate, and I thank my noble friend Lord Hunt of Wirral for raising these important issues and all noble Lords who have spoken very eloquently. I share the wish that we had more time to debate these matters.
	Just three months ago, my right honourable friend the Secretary of State for Health published the White Paper, Equity and Excellence: Liberating the NHS. It is an ambitious plan for reform. It is focused around three key purposes, which are the three themes of today's debate: first, to put patients first and for patients genuinely to feel that no decision is made about them without them; secondly, to concentrate not on inputs and processes but on outcomes and to build a culture of evidence and evaluation and for innovation and evidence to drive quality care; and thirdly, in aiming to deliver the best care, we must empower the people whose responsibility it is to deliver that care. We will give general practice the power to commission services on behalf of patients, combining clinical decision-making with control of resources.
	The Government are determined to improve the quality of the NHS and the outcomes for patients. Our ambition is clear: it is for the health outcomes in this country to be among the best in the world. Today, the NHS has some of the best people and the best facilities in the world, and I do not in the least belittle the improvements made to the NHS by the previous Administration, but the fact of the matter is that when it comes to what is really important-to outcomes-we lag behind. I hope that all noble Lords agree that patients deserve better. The NHS can be better, and with the reforms we have set out in the White Paper, it will be better. I know that there is a wide range of opinion about the White Paper. There always is when you try to do something substantial and challenging, but the Government have been encouraged by the widespread acceptance of the vision that we have set out and the principles of our reforms.
	To deliver the best care, we must empower the NHS staff whose responsibility it is to give that care. In essence, GP-led consortia, led by GPs in close partnership with other healthcare professionals, will establish the range of services and contracts needed to give their local population the high-quality services they need and the choices they want.
	The success of GP commissioning decisions will be determined by the relationships that they develop with others. Local specialist community nurses will be there to help GPs design the best community services, just as hospital consultants will be essential for designing specialist pathways before, during and after a period in hospital. Local authorities will be crucial for helping to integrate health with other local public services to optimise outcomes.
	GP commissioning will not turn GPs into managers but it will enhance their role as leaders. When it comes to day-to-day managerial and administrative tasks, consortia will have a separate budget with which to buy in the support that they need, be that from a local authority, a charity, an NHS provider, an independent contractor or elsewhere. I say to the noble Baroness, Lady Thornton, that, in effect, there are going to be pilots. We plan to roll out pathfinder consortia over the next few months that will indeed pave the way and learn lessons that others can follow. GP commissioning also opens up the potential for working closely with local authorities.

Baroness Thornton: My Lords, the pilots will be running at the same time as the legislation is going through Parliament. I fail to see how that will influence the legislation.

Earl Howe: My Lords, under current powers introduced by the noble Baroness's own Government, GP commissioning can take place within certain limitations, but it is possible for GPs to engage now in the kind of joint working that we envisage and indeed that her Government put in place. I see no inconsistency there, and I think that that will helpfully inform our debates on the Bill.
	GP commissioning, as I said, opens up the potential for working closely with local authorities to jointly commission services, even for the pooling of budgets to tackle local priorities. For example, by working closely with the local authority and social care providers, far more can be done to help older people or those with a disability to live independently, reducing their reliance on the NHS by avoiding things such as hospital admissions.
	GPs will lead but they will not be alone. The NHS commissioning board will be there to support and advise GP commissioners and to share and spread their experiences. There will be no need to reinvent the wheel hundreds of times. One thing that the commissioning board will do as little as possible, though, is tell health professionals how to do their job.
	We will also give far more power to patients. Research clearly demonstrates that treatment is better and often cheaper when the patient is an active participant in their care, not simply a passive recipient. In the coming years, we will give patients real control over when, where and by whom they are treated. They will be central to all decisions about their aftercare, often-where appropriate-spending their own budget in a way that suits their needs rather than the needs of the system.
	Personal choice will not be the only way that people will be able to shape their care; they will also have a say in how local services develop. Strong local democratic accountability will be an essential part of the new system. Patients will have a strong voice in local decision-making through local authorities and HealthWatch, a new patient champion. For the first time, local people will have real powers of scrutiny over local health services.
	We are very good at treating ill health in this country but we are less good at preventing it. We have the highest rates of obesity in Europe, rising levels of drug and alcohol use and, despite recent falls, stubbornly high rates of smoking. As a result, nearly one-quarter of all deaths in England stem at least in part from an unhealthy lifestyle. We have to do far more to stop people from needing treatment in the first place-to keep people healthy. We need a new emphasis on public health. Later this year we will publish a second White Paper on public health. Its aim will be to transform our approach to public health, protecting the public from health emergencies such as swine flu and improving the nation's overall health and well-being.
	I turn to some of the questions that have been asked. As I said earlier, the debate has ranged far and wide, and there have been a great many questions. We are short of time and I apologise to those noble Lords to whom I shall have to write, but I shall endeavour to cover as many topics as I can.
	The speech of the noble Lord, Lord Winston, was uncharacteristic of him. I am sorry that he does not buy into the vision that we have set out. I am sorry that he does not think that we published the White Paper in good faith. The noble Lord gave the House to believe that the considerable efficiencies which we have signalled to the NHS it needs to achieve over the next four years were initiated by this Government. He will, I am sure, recall that they were in fact instigated by the previous Government. They are necessary and have nothing whatever to do with the Government's White Paper. We need to treat more patients for approximately the same money without diminishing quality. That is the challenge.
	I could hardly believe what the noble Lord said about the research budget. The announcements that we have made about research, arising out of the spending review, have been widely welcomed by the research community. We were clear that we wanted to protect science and we have done so. In the current economic climate, that is exceedingly good news.
	The noble Lord, Lord Turnberg, in particular, should be reassured of our commitment to the promotion and conduct of research as a core NHS role. The White Paper makes that commitment clear. It also commits the department to a culture of evaluation. The reasons are straightforward. Research provides the NHS with the new knowledge needed to improve health outcomes. Research enables the department to know whether our policies are effective, cost effective and acceptable. The Government are committed to maintaining a ring-fence on research funding and will cut the bureaucracy involved in medical research. Work is in hand to achieve that.
	The noble Lord, Lord Winston, also expressed scepticism about the whole idea of measuring health outcomes. Again, I was astonished that he, of all people, should pour cold water on our wish to do so. Just because it can sometimes be difficult to measure certain outcomes in a meaningful way does not mean that you should just give up. Great care must, of course, be taken when interpreting outcome indicators. You cannot simply make black-and-white judgments. However, if we focus only on processes, we risk creating a whole system of accountability that has lost sight of the overall purpose: improving the health of patients.
	The noble Baroness, Lady Wall, asked me to underline the importance of local decision-making in the NHS. I readily do so. Those in a position to know what services are required to meet the needs of their patients are those closest to those patients-not politicians in Whitehall, but local doctors in general practice, local doctors and managers in hospitals and patient groups with local knowledge. All of this is part of our vision, which we intend to give substance. I was grateful to the noble Lord, Lord Mawson, for all that he said on this.
	I welcome the remarks of the noble Lord, Lord Beecham, about health and well-being boards. It is not only they that will be scrutinising their own activities. As part of the public health service, health and well-being boards will be subject to quality and outcome standards set by the Secretary of State, and will be supported in their efforts by the public health service centrally.
	The noble Baroness, Lady Masham, spoke in her characteristically impassioned way about patient safety. I agree with her that patient safety is absolutely vital. It is a key domain of our proposed outcomes framework; a key part of the quality agenda. My noble friend Lady Knight will, I am sure, agree that the most important thing that we need to do is bring about an open and transparent safety culture within all NHS organisations, a culture that is open about when mistakes are made and in which the number of serious incidents falls. Most importantly, it must be an NHS that learns from its mistakes.
	The noble Baroness, Lady Masham, referred to the case of the tetraplegic man in Wiltshire whose life-support machine was cut off. This is a tragic and deeply distressing case, currently being investigated by the Nursing and Midwifery Council. Under the new registration framework, introduced in April 2010 for NHS trusts, all providers of regulated activities must register with the Care Quality Commission and meet a set of 16 requirements of essential safety and quality. These include a requirement to ensure that all staff have the necessary qualifications, skills and experience, which are necessary for the work to be performed. All agency staff must meet the same professional standards as permanent staff, as set out by the independent regulator, the CQC and each local safeguarding board. The Department of Health expects all NHS trusts to ensure that they employ appropriately qualified and supervised locums and agency staff.
	My noble friend Lady Miller set out her view on which outcomes patients want. Her remarks were very helpful. I am pleased that there appears to be much commonality between what she set out and what was included in our proposals for the NHS outcomes framework. At the highest level, the outcomes that we felt mattered were preventing people dying prematurely; enhancing the quality of life of patients with long-term conditions; supporting people to recover from acute episodes of ill health and following injury; ensuring people have a positive experience of care; and, finally, treating people in a safe environment and protecting them from avoidable harm. Those domains get very close to what most of us would regard as a synoptic view of what good outcomes mean.
	The noble Lord, Lord Turnberg, spoke about the need to achieve integrated care across primary and secondary sectors. I agree with him. The purchaser and provider split that the White Paper refers to must not be seen as a reason or excuse for GP consortia not to seek the advice, support and collaboration of clinical expertise on the provider side to ensure that the best possible services are commissioned for patients.
	The noble Lord, Lord Mawson, asked how we can ensure that GPs will work across the community and public sector generally. Health and well-being boards have a critical role to play in co-ordinating a strategic patient-centred approach at a local level. GPs, local community representatives and democratically elected councillors will be tasked with making sure that they act on behalf of their patients and communities to deliver integrated services. A board will have a formal duty to involve and consult local people.
	The noble Lord, Lord Beecham, asked in particular how GP consortia will work with local authorities. We have proposed that local government should have an enhanced responsibility for promoting partnership working and integrated delivery of services across the NHS, social care, public health and other services. It will be important for GP consortia to work in partnership with local authorities-for example, contributing to joint assessments of the health and care needs of local people and neighbourhoods, and ensuring that their commissioning plans reflect these needs.

Lord Beecham: What steps will be taken to ensure coterminosity between consortia and the relevant local authorities?

Earl Howe: This is obviously an issue that is in the minds of those of us in the department as well as those in the health service more widely. It is difficult to give the noble Lord a clear answer at this stage. Coterminosity does help; I agree with him. However, it is too early for me to tell him exactly how consortia will be configured. We can return to that issue.
	As part of the consultation exercise, we specifically asked GP practices to begin making stronger links with local authorities and to see how they can best work together. We are currently reviewing the responses that we have received on this.
	My noble friends Lord Alderdice and Lady Hussein-Ece spoke well about having informed and engaged patients. This goes back to what I was talking about a moment ago-"no decision about me without me". That principle is a critical plank of our policy. Shared decision-making means patients jointly working with clinicians to ensure better outcomes and higher satisfaction. As my noble friend Lady Fookes said, the idea is to make the NHS genuinely patient-centred.
	My noble friend Lady Hussein-Ece made the vital point that our need to focus on outcomes must reach well beyond simply measuring clinical outcomes. We need to measure patient-reported outcomes as well as patient experiences. Our proposed outcomes framework, as I have just outlined, seeks to do this. However, it is not all about measurement. It is critically important that all parts of the system, whether providers or commissioners, listen to and engage with patients, patient groups and the public more widely about their concerns and ambitions. That is exactly why we have set out proposals to strengthen the patient voice in the new system. The design of HealthWatch draws on the best of previous models of patient and public engagement.
	With great respect to the noble Lord, Lord Rea, I fundamentally take issue with his point that all the major health think tanks disagree with our reform proposals. Most, if not all, agree with the vision of a health service judged against outcomes with the patient at the centre of commissioning and provision. The questions they have asked-they are natural ones-are mainly around the implementation. We have consulted on the implementation and will publish our response to these consultations. I look forward to debating the details of our proposals with him and the noble Baroness, Lady Armstrong, when the Health Bill reaches the House. I say to the noble Baroness, Lady Thornton, that that is likely to be in the spring of next year, although I hope that she will not hold me to a precise date.
	The noble Lord, Lord Rea, asked us to rethink the whole idea of GP commissioning. I say to him that reform is not an option but a necessity if we are to sustain and improve our NHS. The fundamental problem is that PCT commissioning is remote from patients and does not have sufficient involvement of GPs and clinicians, who are those closest to patients and whose referrals and decisions incur the expenditure of the NHS budget. They are the people who can do much to improve the quality of care, but it needs to be clearly understood that our proposed model does not mean that all GPs have to be actively involved in every aspect of commissioning. A smaller group of primary care practitioners is likely to lead consortia.
	I could address many other matters and I am sorry that I do not have time to do so. As I say, I will write to noble Lords. I apologise to them in that the clock is against us. I hope that we can come back to these matters. Suffice to say now that we are living in a financially constrained environment. An extra penny spent on new cancer drugs is excellent. We have the luxury of being able to spend those extra pennies within the confines of a protected budget and of being able to plan on the basis of stable finance over the next three years, unlike colleagues in some other departments. We also have the luxury of being able to plan for higher quality, integrated, patient-centred, outcome-focused health services led by clinicians and patients. I look forward to doing that. Leadership is about making hard choices in difficult times. The choice we have made is to put health first, and the way to do that can be put very briefly-we need to trust the NHS.

Lord Hunt of Wirral: My Lords, it remains for me to thank everyone who has participated in a debate which I believe shows this Chamber at its very best. Some direct, penetrating and important questions have been raised and we have had the benefit of informed, expert advice from those who really know what is happening on the ground and who are involved professionally. Specific issues have been debated.
	We all respect my noble friend Lord Howe as a caring, compassionate Minister. The way in which he has sought to respond to almost to every point that was raised shows him at his best. Some noble Lords who have participated in the debate are still experiencing the aftermath of a rather difficult election year, but if we are to have a five-year Parliament we face the prospect of just one general election in the next 10 years-perhaps two in 15 years. Many speakers have told me privately that they would love to achieve consensus as the NHS is a great institution. The principles on which it was founded are as important now as they were then-namely, that it should be free at the point of use and available to everyone based on need, not ability to pay. Some still maintain that conflict exists, but the White Paper gives us all a chance to unite to try to create a better National Health Service. This debate is an important step in the right direction as we discuss how best to drive up standards, deliver better value for money and create a healthier nation. I beg leave to withdraw the Motion.
	Motion withdrawn.

Education: Languages
	 — 
	Question for Short Debate

Baroness Coussins: To ask Her Majesty's Government what importance they attach to the teaching of modern languages in schools and universities.

Baroness Coussins: My Lords, modern languages finally hit the headlines this summer. The tipping point was reached when French disappeared from the top 10 GCSE subjects for the first time ever; A-level entries dropped; university departments began to anticipate the cuts by planning reductions in modern language courses; and, to cap it all, schools and local authorities realised that, despite years of investment, languages were no longer to be made compulsory in primary schools. The bleak picture was compounded by the publication last month of an OECD survey that showed that secondary school pupils in the UK spend less time studying languages than their counterparts anywhere else in the developed world. Only 7 per cent of the lesson time of 12 to 14 year-olds is allocated to languages, which is half the amount that they spend on sciences. This puts England joint bottom of a table of 39 countries, alongside Ireland and Estonia and behind Indonesia and Mexico.
	This provoked a flurry of articles and comments on why it is important that we get better at languages. Having one or more languages in addition to English is a huge asset to anyone competing in a global labour market at whatever level. Your Lordships' House has debated before the serious disadvantage to UK business and competitiveness of the lack of language skills in the workforce, and I shall not repeat that argument today. In addition to the business case, knowledge of other people's languages opens doors to understanding other people's cultures; and competence in languages provides us with the wherewithal to function in international institutions and to participate in research. The UK's capacity in all these areas is now dangerously low, and we will suffer serious commercial and cultural damage unless we inject a new urgency and commitment into our national approach to learning languages.
	The forthcoming review of the national curriculum, and the conclusion of the noble Lord, Lord Browne, in his recent review of university funding, that languages should be a priority subject for public investment, suggest that the timing is right for nothing less than a national languages recovery programme-and I ask the Minister to acknowledge that putting it in such bold terms is absolutely warranted. I also thank the Minister for stepping in at such short notice to reply to this debate, and ask her to convey all our good wishes to the noble Lord, Lord Hill. The All-Party Parliamentary Group on Modern Languages, which I chair, will be making recommendations to the curriculum review. I should be grateful if the Minister would tell the House when this will be announced and what the timetable for consultation will be.
	Today, I will simply flag up some of the issues around languages that I believe must form part of the review. First, we must begin to put right the disastrous consequences of the policy to make languages optional at key stage 4. The decline in GCSE entries from 2004 has been severe. The vast majority of state schools neither insist on a language post-14 nor even set a benchmark for take-up, as they are meant to do. As a result, languages have become one of the main causes of what the coalition Government have called the "vast gulf" between state and independent schools, with pupil take-up at key stage 4 being only 41 per cent from comprehensives, compared to 81 per cent from independent schools and 91 per cent across all selective schools.
	I do not believe that it would be right to force every child to take a language GCSE, but I do believe very strongly that it should be compulsory for every child to study at least one modern foreign language until they are 16, at a level appropriate to them. Fortunately, the Government do not need to reinvent the wheel to apply this model, because the Languages Ladder provides exactly that flexibility. It is a national recognition scheme to reward achievement at all levels, from beginners through to advanced and proficient language learners, and it is calibrated against the Common European Framework of Reference. Will the Minister undertake to look at this as a way of restoring compulsory language teaching up to the age of 16? I noticed recently that one of the major teacher unions, the NASUWT, has come out strongly in favour of compulsory language teaching at key stage 4, and some forward-looking schools are beginning to restrict access to the sixth form to those with a language GCSE.
	Given the complete failure of the benchmarking strategy to increase take-up, but also given this Government's stated desire to loosen central control over schools, I ask the Minister how the Government plan to make schools accountable for improving take-up and attainment in languages.
	What about primary schools? We had 92 per cent of primary schools teaching languages in mainstream curriculum time, in anticipation of a statutory framework from 2011, only to discover that the pre-general election wash-up process had resulted in this long-standing commitment being abandoned. The risk now is that, without a statutory requirement, some schools and some LEAs will drop languages again. Certainly I believe that if compulsory language teaching up to the age of 16 is not reinstated, many other primary schools will surely not think it worth investing in language teaching for their seven year-olds, only to send them to secondary school aged 11 where their achievement may not be valued or built on. A survey only last month showed that 75 per cent of local authorities positively want languages to be made compulsory in primary schools, so will the Minister agree that the Government should revert to plan A and do just that?
	My final point on schools, before I move on to universities, is to urge the Government to get the people who create the exam syllabuses to be more imaginative. If all that children do for GCSE is more of what they have done between the ages of 11 and 14, and that centres on endless descriptions of what they did over the weekend or describing their family members to an imaginary penfriend, no wonder they are too bored to carry on with it. Research from Australia and Scotland shows that children value and want to do subjects that are seen as serious, even if they find them hard. Too often, the relevance of languages is pitched to children in terms of sport, fashion or going on holiday, but in my view the appeal that would hit home more effectively, as well as being more grounded educationally, would be the relevance and workings of grammar and the whole structure of language, including English, to the child's capacity for self-expression, intellectual challenge and understanding in the context of a world where it will be a serious disadvantage to be monolingual, even if your one language is English.
	Some universities, like some schools, are beginning to acknowledge the importance of languages in their admissions policies by introducing a language requirement for all applicants, irrespective of degree subject. This is certainly a welcome step for the universities concerned but it is also significant for schools, which will need to take those universities' requirements into account when structuring their timetables and advising their pupils on GCSE option choices.
	Alongside this, it is very disappointing to see that other universities are looking at cutting modern language provision. Swansea, for example, is considering proposals which would apparently involve 22 academic staff competing for eight posts in a reduced department and the disappearance of Italian, Russian and Portuguese altogether. This is despite the Welsh Assembly declaring earlier this year that the study of modern languages was a "national strategic priority". I hope that Swansea and any other university contemplating cutbacks in their languages provision will take a closer look at the Worton report and resist such short-sighted and damaging cuts in languages. The UK needs to produce more specialist linguists to be teachers, translators and interpreters, but we also need more scientists, economists, lawyers and others who can work in English and in another language. That is important for their employment prospects as individuals and for the capacity of UK universities to compete globally.
	I should like to ask the Minister what specific action the Government intend to take to reinforce the status of modern languages as "strategically important and vulnerable" subjects at university level. The forum set up after the Worton review is one important contribution which I hope will be continued.
	The STEM subjects have rightly attracted attention and strategic investment. Modern languages require the same declaration of priority and leadership from Government to give universities the confidence and incentive to build on their provision, not to diminish it. Professor Worton, in an article in last week's TimesHigher Education supplement, said:
	"The case for modern languages in universities has never been more compelling".
	He asks whether universities have the courage to deliver. I ask the Minister whether the Government will have the courage to do likewise.

Baroness Hooper: My Lords, I thank the noble Baroness, Lady Coussins, for raising this question and congratulate her on introducing the debate so brilliantly. I very much hope that the Minister will be able to reassure us that the Government attach considerable importance to the teaching of modern languages in schools and universities. It is an area which is much in need of encouragement and support.
	The arguments about the value and usefulness of speaking another language have been well made by the noble Baroness, who in her short time in the House of Lords has established herself as a true advocate of this cause. From my experience, I feel that there are two main arguments. First, an ability to think and speak in another language enables us to understand the culture, history and approach of the people speaking that language. That can be very useful in difficult, delicate negotiations and even for a simple transaction such as buying a gift in a market as a tourist. The second is that in learning another language I believe that you understand your own better. That is especially true of English, which is such an unstructured language. A few good rules of grammar learned from French, Spanish or German-in the absence of Latin these days-can greatly improve the quality of English spoken.
	That being said, we are today seeking to find out from this new Government what plans they have to increase and improve the teaching and learning of other languages in the aftermath of the statements earlier this year referred to by the noble Baroness. English is the most spoken language in the world, both as a first and a second language. After English comes Spanish as a first language. I happen to speak it as well as French and German, which I learned at school, and I have found them all useful in both my legal and my political careers.
	Last week, President Piñera of Chile addressed parliamentarians here and said that his Government's intention was to make Chile a bilingual country in Spanish and English. That was in the context of organising more educational exchanges and links between our two countries, particularly at university level. In the short time available, I wish to emphasise that and I hope that the Government will bear it in mind when the consequences of the necessary budgetary cuts impact on things such as Chevening Fellowships, the British Council's education programme and other educational language initiatives. It is vital not only that our students should be able to go abroad to further their studies, but also that young people from other countries should be able to come here and be welcomed and nurtured when they get here. Anything that the Government can do to improve the struggles with, for example, the current visa requirements and restrictions, as well as to increase and focus funding, would be most welcome.
	Finally, I urge a change of attitude. This issue has already been addressed by the noble Baroness, Lady Coussins. We need a change of attitude to the learning of languages, especially among schoolchildren. Just because English is the most spoken language in the world does not mean that our children are more stupid than Dutch or Scandinavian children, who all seem able to grow up speaking three or four languages well and study the other conventional subjects.
	If children can learn the language of computers so easily-something that I have to struggle with-learning another spoken language should be a doddle. That message should be put across to them. Any support that teachers can be given should be encouraged and built on. I mean in this context not only admission policies. Perhaps an increase in the number of competitions and prizes, such as the Canning House essay competition for sixth-formers in Spanish and Portuguese, should be encouraged to underline how important the speaking of languages is.

Lord Harrison: My Lords, this week we have been celebrating the life and work of Baroness Daphne Park, herself a doughty defender of the United Kingdom but also a brilliant linguist. She told me once, knowing of my son's interest as a Russianist, that when she was a raw recruit in Moscow she had said to an old Muscovite, "I like to have a good swim every morning before going to work". Unfortunately, the verbs "to swim" and "to spit" are cognate and what she actually said to the recoiling Muscovite was, "I like to have a good spit every morning before going to work"-a matter of great expectoration, as I said to her.
	In speaking in today's debate, I should like to thank another doughty fighter for modern languages, the noble Baroness, Lady Coussins, who has single-handedly led our modern languages group and has highlighted the lamentable and deteriorating levels of language learning and acquisition in this country. However, I will concentrate on Baroness Park's concerns with the defence of this country. There is an important role to help the British Armed Forces to accomplish their task, as the UK military operates throughout the world, either as UN peacekeepers or in assisting in disaster zones.
	Two factors make language skills very much sought after. First, there is the fight against terrorism-monitoring and interpreting information coming to us-but there is also the winning of hearts and minds in conflict zones. It is not sufficient just to have a passing knowledge of Afghan Pashto or Dari; we need to speak them fluently and sympathetically enough to win hearts and minds. The armed services dedicated training centre, the Defence School of Languages at Beaconsfield, is important. Have languages featured in the recent defence review? Has the defence school been affected by departmental cuts? What is its capacity? Does it need expansion? What are the recruitment patterns? I point out that 70 per cent of linguists coming out of university are women, whereas men predominate in the armed services. Does that cause a problem? Will the Minister think about the Territorial Army, which I should have thought was good ground for increasing language knowledge within the Army?
	The head of language engagement at GCHQ, the Bletchley Park of language code breaking, said recently that GCHQ is obviously affected by the parlous trend of the take-up of language learning in the United Kingdom. Indeed, so challenged has it been that it is now going out to schools and universities to encourage recruitment. I am not sure that it should be doing that, but there we are; it has to because we need those young people. How does GCHQ work? Typically, most recruits come with French and other European languages. Then at GCHQ they are taught languages that are needed for intelligence-typically, the languages of the Middle East, the Near and Far East and Africa. We are told that languages are not taught as they are in typical language classes:
	"In the Albanian ab initio training course, we effectively train linguists to speak Albanian badly".
	We need more linguists to speak badly, if badly means that that they understand the stream of consciousness language-sometimes grammatically illiterate-which they then have to interpret and from which they need to draw the intelligence that is so badly needed for the defence of this country. Will the Minister say whether the prohibition on non-Brits working at GCHQ could be lifted if they were properly vetted?
	As to the scandalous racism, which leads to the fact that the top 60 senior civil servants at GCHQ are all white, we need to tap into those black and ethnic British who want to defend our country. We should do so because they have the first-hand knowledge of languages that we badly need in defence and security.

Baroness Sharp of Guildford: My Lords, I join others in thanking the noble Baroness, Lady Coussins, for bringing this debate. As the noble Lord, Lord Harrison, said, she is a doughty champion for modern foreign languages. I wish her well in her campaign. As the noble Baroness said when she introduced this debate, the rot really set in in 2004, when we reluctantly as a House agreed to allow the noble Baroness, Lady Ashton, to drop the requirement from the national curriculum for a modern foreign language to be compulsory in key stage 4. That deal with the noble Baroness was in return for languages being made compulsory in primary schools. The rolling out of the primary school programme for teaching modern foreign languages was introduced at that time. I have to say that I am extremely distressed that this has now been dropped.
	The agreement followed on from a report by the Nuffield Foundation. Looking at why Britain was so bad at languages, it came up with the answer that, in countries such as the Scandinavian countries and Holland, English was taught from a very early age. It was taught in primary schools. Thus, children were already somewhat fluent when they arrived at secondary school, where it was reinforced by further study. The report suggested that children learnt languages better at the ages of seven, eight and nine than they did later and that, therefore, it would be a good idea to teach languages in primary schools.
	The other idea was that languages should be taught like music. If you were good at languages you could attain grade 8; if you were less good you could do grades 1, 2 or 3, or something like that, and stop at that point. That notion-the Language Ladder was referred to by the noble Baroness, Lady Coussins-has translated the teaching of modern foreign languages into precisely the music grade system, which is to be welcomed. It provides a good foundation from which young children learning languages at primary school can develop their language skills. It is doubly unfortunate that we now propose to drop the programme of teaching languages in primary schools.
	I certainly remember having tea with the noble Baroness, Lady Ashton, and talking to her at some length about the idea that, while we did not have people trained in modern foreign languages with degrees to teach them in the schools, we nevertheless had a great many native speakers. If we presume to send people abroad to teach English as a foreign language after six weeks' intensive training, there is no reason why many native speakers in this country could not be trained as teaching assistants to teach, particularly in our primary schools, to the level required.
	One of the unfortunate things about the primary school programme is that, while teaching modern languages was great fun, it was often for little more than half an hour a week because of the requirements of the national curriculum and the lack of time in those schools. It requires not half an hour a week but half an hour every day with a language assistant, which helps someone to become fluent.
	I entirely agree with the points made by the noble Baroness, Lady Hooper. Learning a language helps you to understand your own and to use your own language. It is a very important skill. I am very sorry to see it being dropped and I hope that my noble friend the Minister will assure us that the Government will give it high priority and that we shall be reinforcing these programmes.

Lord Broers: I, too, thank the noble Baroness, Lady Coussins, for bringing our attention back to this vital subject. I am speaking today because I believe that knowledge of more than one language enhances one's breadth of outlook and intellectual acuity, especially for those trained narrowly as scientists and engineers. It is not only the obvious practical benefits of being able to work with and to operate in other countries that are of great importance, but the effect that it has on one's intellectual capability.
	I wish to share with the House what I learnt following a BBC World Service programme a couple of weeks ago. Some noble Lords may have heard the programme or know about the work described, which is relevant to this debate. Professor Jared Diamond of UCLA was talking about the work of Professor Ellen Bialystok of York University, Toronto, who has shown that bilingualism gives children a distinct cognitive advantage over their monolingual peers. She has found that bilingual children outperform monolingual children on tasks involving executive control. These comprise the cognitive processes that allow for abstract thinking, planning and initiating and inhibiting actions. Three separate experiments on six year-old students demonstrated that children who routinely spoke more than one language could better focus on pertinent information and suppress their attention to a distracting or irrelevant item. Her surprising finding was that bilingual children performed better than monolingual children not only on the difficult condition that involved alternating between letters and numbers but also on the simple condition in which they just connected consecutive numbers.
	Stimulated by her results with children, Professor Bialystok joined Dr Fergus Craik, a neuropsychologist at the Baycrest Centre for Geriatric Care in Toronto, to go to the other end of the age scale and see whether similar effects were present in healthy adults. They looked at the records of 184 patients diagnosed with dementia, about half of whom were fluently bilingual, speaking two or more languages daily. It turned out that the onset of dementia was an average of 4.1 years later for the bilingual patients than for those with only one language. The theory is that bilingual people are constantly having to use their attentional control system, thereby increasing its capacity, which appears now to help to resist the effects of dementia and Alzheimer's.
	Those findings fitted with evidence from post-mortem studies, which have shown that about a third of people with the physical symptoms of Alzheimer's, such as amyloid plaques, had no cognitive impairment before they died, meaning that their brains somehow fought off the disease. Perhaps there is hope for us monolinguists yet, but we will have to become fluent in another language. The Toronto scientists did not find these effects in those with a knowledge of a language but who were not fluently bilingual.
	All this reinforces what I have long believed and what led me to work with Ann Dowling and Sarah Springman in the Cambridge University engineering department to set up the language programme for engineers, about which I spoke in the debate on this subject-also called by the noble Baroness, Lady Coussins-last December. I am pleased to report that this programme remains popular, with almost 800 students participating this year. However, it would be even stronger if more students had studied languages in school.

Lord Hannay of Chiswick: My Lords, it is welcome that my noble friend has secured today's short debate on the teaching of modern languages in schools and universities. For some years now the general weakening in Britain's performance in this area of education has been alarming and it has shown no signs yet of being reversed. We all owe a debt of gratitude to my noble friend for her untiring work as chair of the All-Party Parliamentary Group on Modern Languages, and the number of speakers in the debate shows just how wide is the unease about recent trends. I hope that the Government will take careful note of that and will act more effectively to address the underlying problems.
	Government policy in recent years, while paying lip service to the existence of a problem, has done little about it. The welcome acceptance of the recommendation of the much missed Lord Dearing, that modern languages should become part of the primary school curriculum, which is now fading away, was matched-undermined, you might say-by enabling it to be dropped from the secondary school syllabus. Now, with the Browne report on higher education finance, the Government are being urged to include what are quaintly called strategic modern languages among the group of subjects on which the much truncated teaching grant to universities should be concentrated in future. Do the Government intend to accept that recommendation and what do they understand to be strategic modern languages?
	The case for reversing Britain's increasingly poor performance in learning modern languages can be argued at many levels. I shall focus for the moment on the utilitarian. The Government are quite rightly determined to improve Britain's performance as an exporter. They want Britain's diplomats to concentrate more on that part of their job. It is not a particularly original idea; it has been tried several times in the past. But contracts are won and retained not by diplomats but by businessmen. If fewer and fewer of our businessmen are competent linguists, there will be fewer and fewer export successes. The expansion of our intelligence services is a national priority in the battle against terrorism, but where will competent linguists be found for the intelligence services? A Britain whose relative weight in an increasingly interdependent world is dropping will need to co-operate and build alliances more than in the past. Do we believe that simply expecting everyone to speak our own language and to work in our language will facilitate that?
	If one looks out beyond the purely utilitarian arguments, it is surely sobering to think of how we narrow our understanding and perception of other cultures and literatures if we have no knowledge of their languages. How are our world-class universities to retain and improve their standing and reputation for academic excellence if their capacity to study, research in and teach modern languages is continually declining? I hope that the Government will now take a deep breath and look again at the whole range of issues that influence the role of modern languages in our education system. Needed are not just warm words but effective action to reverse the present downward trend.
	I welcome the Minister to the Front Bench. She is a loss to our sub-committee in the EU Select Committee system, but she is a great gain to the House.

Baroness Butler-Sloss: My Lords, I am delighted that this important debate is taking place and I congratulate the noble Baroness, Lady Coussins, on introducing it. I share everybody else's concern about the loss of languages in schools and universities, but I am concerned also by the failure of the general public to take an interest in languages or to see any need to be concerned. I suspect that they generally think that English is universal and see no reason to worry about anything else. This is unacceptable complacency, when we need to remember that we live in a global community. On a visit to China, I was embarrassed to find that all the delightful young women who were looking after the group that I was with spoke impeccable English, yet none of them had ever left China. It really is an embarrassment.
	I recently went to Bordeaux. That was not an embarrassment, nor was the reason that I went. It was for a wine-tasting with a small group of people and it was a delightful visit. However, two men in our small group could not even read the notices in French, but they were the leading experts in wine and regularly visited Bordeaux. They were actually rather proud of the fact that they did not speak French. I am glad to say that the women in our party were much better at French than the men, which is not all that unusual.
	Our young people must be encouraged to take an interest in languages and the way of life of other countries, which follows from learning their language. It is a crucial part of the general education of young people. What will the Government do, or what do they think they might be able to do, to change a wide culture or, rather, lack of culture towards foreign languages and the way of life of other countries?

Lord Cobbold: My Lords, I am pleased to have the opportunity to support the noble Baroness, Lady Coussins, in her Question to Her Majesty's Government. The teaching of modern languages to the young is a matter of great importance. We must not allow ourselves to take the line that, because English has become the leading global language, there is no need for us to learn another.
	While the importance of English is a huge advantage, it has its problems. In a recent European Commission survey of Europeans' non-mother-tongue skills, Britain came last out of 28 countries. Languages are crucial to our success in the European, Asia/Pacific and Latin American markets. It is said that only one-third of UK university graduates are confident enough to go and work abroad compared with two-thirds in other European countries, so we are not gaining international expertise that could enrich the UK skills base.
	Many international companies look for language skills when recruiting and those with language skills tend to get the most interesting and best-paid jobs. Skill in languages is something that children of a very young age can develop and it is therefore good that language teaching is encouraged in primary schools. But it seems very unwise that it should not also be encouraged in secondary schools, thus providing continuity between primary school and university. I hope that the Government will rectify that admission.
	The question then is, which languages should be taught? At the European level, French, German and Spanish are the leaders but, given increasing globalisation, and particularly the rise of China, increasing attention should be given to the study of Mandarin and other Asian languages.
	There is one issue on which I have some doubts and that is whether it is good policy to include the study of Latin in the curriculum. There is no doubt that the study of Latin is a good introduction to grammar, the structure of several European languages and a wealth of classical history and art, but I remember from my own experience many years ago wishing that the time spent learning Latin could have been better spent on a modern language. Indeed, we used to say: "Latin is a language, as dead as dead can be. It killed the ancient Romans and now it's killing me". That is a trivial matter of personal experience long ago and in no way detracts from the importance of modern language teaching in our schools today. I hope that the Government will acknowledge this importance and, in particular, move to make the teaching of modern languages obligatory at secondary school level.

Lord Lyell: My Lords, what a pleasure it is to be able to thank the noble Baroness, Lady Coussins, once again for introducing this timely debate. As we have heard and will hear a lot more, it is an important debate,
	I hope that I have not bored your Lordships, let alone the noble Baroness, in the past, with my desperate inability to grasp the baser elements of science. That was until I came to your Lordships' House. My school years up to 1956 were enlivened by learning languages. Indeed, one of the prime elements in my language lessons was the housemaster or tutor of the noble Lord, Lord Cobbold, who has just sat down. I remember in 1954, he put me through the elements of German, the classics of Greek and Latin and slotted me in perfectly.
	The years to 1956 were enlivened by what I call the "dog jumping through the hoop" syndrome. In other words, you learnt verbs one to 33 in French. You learnt about pleonastic "ne" and what Rochefoucauld meant to say or not-I apologise to the noble Lord, Lord Jay. When you finished the exams, you felt rather like the galley slave once again brought to shore; you felt safe.
	I have had the enormous good fortune to spend over 40 years in your Lordships' House, and I have taken language courses, sometimes here in your Lordships' House and sometimes at a professional language school. Indeed, quite often there have been repetitive lessons from a book, but they have enabled me to take the first step in some European countries.
	My mindset after leaving school was one of pure pleasure in that I discovered a world-famous daily sporting paper, L'Equipe, of which I have a copy here today. I hope that my noble friend on the Front Bench will not tut too much; I shall not read from it, as one should not produce newspapers. But for many young schoolboys and perhaps young schoolgirls, and indeed in primary school, this may be the first step to enliven what is a set language-not just to learn like dogs jumping through hoops, but to learn terms for football, tennis or other activities in other languages. So far I have tried these particular disciplines in German and Italian, while Spanish, Portuguese and oriental languages were spared my young efforts. I had the time when I was in the Northern Ireland Office to go to huge food fairs, mainly in Europe-Cologne, Berlin, Paris and a very instructive morning in Lille. These were exhibitions and trade fairs connected with agriculture and food, my main responsibility in Northern Ireland. On every occasion I had the good luck to meet Ministers and senior officials, and my languages seemed to put me and the Northern Ireland Office in their good books. It taught me the real value of top-class, professional language training.
	We have heard and will hear more that English is very much the language used all over the world, but I make a plea to my noble friend to give the very highest award to targeted professional language training directed towards business. Earlier this month, I attended a special function at our leading Scottish business school at Heriot-Watt University, and the great plea I heard there was to target professional language training to the particular aspects of business and overseas trade. Indeed, much of that trade and the disciplines are in English, but if you can make one or two efforts in the language of your host, you will gain that extra yard and gain success-not only for your firm but, above all, for business.
	I am not entirely aware of the systems of language laboratories, because I am too old to have experienced that. Learning languages was done with the aid of a book, newspapers and, as American footballers say, grinding out the yardage of proper grammar. I make a plea to the Minister to see whether she has any good news about laboratories with personal headphones. It may be a question of cost, but it would cost a good bit less than some of the traditional means we have heard about.
	I conclude by thanking the noble Baroness, Lady Coussins, for introducing this debate and hearing me once again on my pet subject.

Baroness Sherlock: I add my voice to congratulate the noble Baroness, Lady Coussins, and pay tribute to her expertise and determination in this area. I do not share her expertise, but I was inspired to contribute to this debate by a visit to a school. I have the good fortune to live in the city of Durham, but I have discovered recently that only 38 per cent of students in our authority study a modern foreign language up to GCSE or equivalent. That is despite the fact that we have three large schools in the authority that are specialist language schools; indeed, without those three schools, it would be only 30 per cent. Last month I visited one of those three, Durham Johnston Comprehensive School, and I was hugely impressed with the staff and the students. It is a good school but, in particular, they showed what can be done if the leadership of a school sets out to tackle the problem described in this debate and tries to persuade parents as well as students of the wider value of language learning. A school that does that is up against some fairly serious odds, as it is hard to persuade students and parents of the value of language when we do not appear to value it as a society. Schools risk falling down the league tables when they choose to promote languages over other subjects perceived to be easier academically. That is a risk for a school to take. That price becomes ever higher as the base of those taking languages at GCSE becomes narrower.
	Some schools are struggling to recruit experienced language teachers, and there is a noticeable gender issue, with languages being seen to be for girls-which the noble and learned Baroness, Lady Butler-Sloss, has clearly discovered is not just for those still in school. Recently the head of languages in a large specialist language school told me that for the past six years he has been the only male teacher in the language department in that school. He also mentioned a school in Newcastle where, because it was a boys' school, more boys are doing A-level languages than in the whole of the rest of the north-east. Will the Minister consider this in her closing remarks?
	So what else can be done? I share the comments of noble Baroness, Lady Coussins, and another colleague about the importance of the statutory framework for primary school teaching. Will the Minister say how, during the curriculum review, she might ensure that that work carries on, so that the momentum is not lost? My understanding is that the funding that goes to training those local authority advisers-the people who actually train non-specialist primary teachers to use their language skills to introduce a language-will run out in March. Can she confirm that and, if so, tell me how she might maintain that momentum while the curriculum review is taking place?
	Secondly, I should like the state to find a way of supporting schools such as Durham Johnston which are trying to promote languages, by incentivising or rewarding them in some way. It should remove any disincentives in league table terms. We certainly do not want to put schools off when they are enthusiastic about languages. As other noble Lords have mentioned, GCSE examinations could do with some serious overhaul. The current, rather binary pass/fail outcome does little to encourage students to take those exams and does not recognise the range of achievements that they may have. Students may be good at speaking or reading, or reach different levels. That is something which examinations could usefully recognise and it would encourage more students to proceed.
	I endorse the calls of other noble Lords for action to support language teaching in higher education. In particular, I support the call of the noble Baroness, Lady Coussins, asking the Minister to urge her colleagues to make sure that they directly engage with the forum led by CILT, the National Centre for Languages, set up in the wake of the Worton review. Will she look at the lead set by UCL, which now requires undergraduate entrants either to have a good GCSE in a modern language or to consider studying one when they arrive?
	Languages are at risk of becoming elite subjects. Pupils at independent and grammar schools study them, many top universities teach them, but fewer other institutions do so comprehensively. I should like everyone to have that chance. I am a bad example. I studied French and German to O-level and, I confess to the noble Baroness, Lady Coussins, that I use them almost never. I do so occasionally on holiday and in restaurants, but I very much want future generations to have the chances that I had, and I feel confident that they would make rather better use of them than I did.

Baroness Benjamin: My Lords, I was going to speak in French today but was told that that may be a faux pas. So I said to myself, "C'est la vie". However, I am very glad to be speaking in this debate and thank the noble Baroness, Lady Coussins, for initiating it because the subject affects children's long-term ability to communicate effectively when they go out into the big wide world. I am interested in their personal intellectual development, commercial advantages, social cohesion through the reduction of xenophobia and their awareness of other cultures. A wonderfully exciting way to achieve this is through the learning of languages. The ability to understand and communicate in another language is a lifelong skill for education, employment and leisure, and provides a sense of global citizenship and personal fulfilment, as we have heard.
	I always find it intriguing how foreign politicians, business leaders, football mangers, and sportsmen and women whose first language is not English are able to answer questions and make statements in a language other than their own-and we expect them to do so. I wonder how many of us could show that same linguistic dexterity. Or would we just, in the good old British tradition, shout louder in the hope of being understood.
	We should be encouraging, improving and increasing the teaching of modern languages in schools as early as possible-from primary education right through to university. Yet this year, for the first time, French, one of the most commonly taught languages in schools, slipped out of the top 10 most popular GCSE subjects. Sadly, less than one in four pupils now sits the French exam. This year's GCSE take-up figures showed the number of pupils taking French and German had virtually halved since 2002. This is a very worrying trend, and at a teachers' conference in London recently, teachers voted by 73 per cent to make languages compulsory again at GCSE level to help promote global understanding.
	It seems to me that anyone with common sense can see that children who do not have the chance to learn a language will be at a disadvantage and will not be given the opportunity to experience the feelings of achievement and self esteem which come from being able to communicate in another language. For primary school children, learning a new foreign language, such as French, as part of the curriculum enhances their understanding of how languages work and of the similarities and differences between them. It can also be taught using a cross-curriculum approach. It gives children for whom English is a second language the feeling of inclusion and achievement as they are learning a new language on a level playing field. It is always wonderful to see how receptive and enthusiastic young children are when they are learning a new language using stories, games, songs, drama and speech with great enjoyment. At the age of seven, children are noticeably adept at imitating the correct pronunciation. I still remember learning my first French phrase, "Ouvrez la fenêtre", meaning, "Open the window".
	However, the window of opportunity to learn the basics of language learning may be lost for some children by the time they reach the age of 11 because by then children are more set in their ways, so we need good teachers from the very beginning in those early foundation years. Teaching languages at universities is vital to this because those university students will go on to teach modern languages in our schools. At the University of Exeter, where I am chancellor, so I declare an interest, I am pleased to say that we have a postgraduate certificate in modern foreign languages programme. Many of our students go on to become heads of language departments in UK schools. We also have a primary postgraduate certificate programme that prepares about 25 students each year as language specialists in primary schools. The courses enable students to explore the exciting challenges that face teachers and learners of modern foreign languages in Britain today. It is vital that we feed students through to universities eventually to become teachers themselves.
	If we are to send our children out into a global competitive world, they need to be well equipped and not to feel inadequate or to be at a disadvantage when it comes to communicating and succeeding. However, as we have heard, there are sadly still too few primary school teachers who are qualified to teach modern foreign languages to our children and start them off on that wonderful journey of exploration. So will the Minister say in winding up what the Government are doing to encourage the teaching of modern foreign languages in our primary schools today?

Lord Jay of Ewelme: My Lords, I, too, am very grateful to my noble friend Lady Coussins for introducing this debate. I begin by declaring an interest as chairman of the NGO Culham Languages and Sciences, which I set up to bring into the state system as an academy the European School at Culham near Oxford. I shall not go into detail, but it is a school of some 900 children between the ages of five and 18 and is the only school in the country that teaches the European Baccalaureate, which is not the same as the International Baccalaureate. That means that 18 year-old school leavers are fluent speakers of at least three languages, and when I say "fluent", I mean fluent. To sit around a table with half a dozen 17 and 18 year-olds who can speak two, three or four languages and see the prospects that are open to them is quite daunting and, to be honest, rather humbling.
	When the school becomes an academy, as I hope it will, I hope that it will be able to work with other schools in the neighbourhood and, through distance learning, with schools outside the neighbourhood in order to encourage language teaching more widely. I am extremely grateful for the support I have had from the previous Government and, in particular, from the noble Lord, Lord Adonis, and from this Government, particularly the noble Lord, Lord Hill, on this project.
	As other noble Lords have said, Britain is international. Internationalism is multilingual, and if Britain is monolingual, it will simply lose out. It is as simple as that. If a firm in the City today has a choice between the most brilliant monolingual English graduate and an equally brilliant French, German or Dutch graduate who speaks three or four languages fluently, including, of course, English, it does not require thought to know which one it will choose. Those of us who live in London, at least from time to time, and hear foreign languages spoken will know how much that is already happening. To become bilingual or trilingual by the time you leave university or indeed school, however, it is hugely important to start young. It is nothing like as effective to start learning French or German at the age of 11, 12 or 13 as it is at four or five. Like my noble friend Lord Cobbold, having spent two hours a day learning Latin from the age of eight to 15, then having had to bring my French up to scratch at six in the morning in order to present to the French authorities the "hard ecu" proposal of the noble Lord, Lord Lawson, I know what that means-it really makes a difference to start young. I strongly hope that the Government will give a high priority to language teaching in our public sector schools.
	Many of our private schools have got the message and are acting on it. Mandarin is increasingly taught, and rightly so. As the noble Baroness, Lady Sherlock, said, though, enlightened head teachers in the public sector are increasingly seeing there too how crucial it is to give priority to languages. However, they need the Government's help-they need a push to do that. The noble Lord, Lord Hill, speaking in a debate earlier today, spoke of a new English baccalaureate that might include an ancient or a modern language. I urge the Government that there should be one compulsory modern language in this new qualification; let the ancient language be the voluntary one.
	Modern language teaching and learning is not a luxury. It is essential to bring out the best in our young to equip them for life in the 21st century, and it is essential for Britain's competitiveness in a hugely competitive age.

Baroness Warnock: My Lords, as the last Back-Bench speaker in this debate I have absolutely nothing new to say that has not been said before. This has been an important debate, and I am grateful to my noble friend Lady Coussins for introducing it and for her tireless work in supporting, and doing everything to rescue, the teaching of modern languages in schools.
	It is a matter of rescue because the teaching of modern languages in the maintained sector is in a terrible condition, as the figures that we have heard show. I hope that the move towards academies, to which my noble friend Lord Jay of Ewelme, has just referred, will enable enthusiastic heads not only to encourage pupils to learn modern languages but actually to insist on it, as well as, if they can, to employ Europeans to teach European languages. That is an important part of what we could do to encourage not just the learning of languages but the enjoyment of doing so.
	In my experience of grandchildren and great-grandchildren, what is wrong with primary school language teaching and, where it exists, secondary school language teaching is not so much the difficulty of getting a good grade at GCSE, of which we have heard we have quite a lot, but the incredible tedium of the way that languages are taught. I can number six grandchildren who have all said to me that what they hate most about school is learning languages. There is something deeply wrong with this, because these children enjoy almost every other subject.
	In order to reintroduce compulsory modern foreign languages at up to key stage 4 and possibly GCSE as well-nothing short of that would do-there needs to be a radical rethink of the syllabus for GCSE French and, doubtless, German and Spanish. There are schools that can do it. One of my children teaches at Dulwich College. She reports that the teaching of Spanish there is not only extremely successful but enormously enjoyable. People choose to do it just because it is fun.
	Children generally have a great love of language. They love words, learning the derivation of words, comparing ways of saying things in one language and another, and the whole business of translation or the possibility of not being able to translate exactly from one language to another. That fascinates them. Why can we not deploy this natural enthusiasm for language, with all the purely linguistic interests of learning a modern foreign language, for all the utilitarian reasons as well?
	Fundamentally, learning other languages is and can be fun; not in order to be able to go shopping, nor even to supply the nuances of business engagement, but simply because language is our greatest human ability. Not to exploit that seems to me to be madness.
	I deplore the move whereby languages were no longer compulsory up to key stage 4. Like the noble Baroness, Lady Sharp, I also have great hopes for the Language Ladder, which was an invention of the late Lord Dearing. In or out of school, having a way of learning language that is analogous to the way of learning music, and examining it in a way that is analogous to the associated board examinations, would be an enormous incentive. Children are pretty ambitious. They like to be able to see where they have got to, and get to the next stage and be better than somebody who is five years' younger than them. They like that kind of thing, and we should exploit that.
	I greatly hope that the Minister will be able to offer some encouraging words about the Language Ladder and, more importantly, about encouraging heads and particularly new academies to branch out and find new ways of learning languages by exploiting love of languages in children.

Baroness Crawley: My Lords, I, too, congratulate, the noble Baroness, Lady Coussins, not only on securing this vital debate but on her persistence in championing the importance of modern languages. I also welcome the Minister to the Dispatch Box this afternoon and send our best wishes to the noble Lord, Lord Hill, from these Benches.
	Those of us who fret over the undeniable truth that so few of us speak any foreign language must answer some direct questions. Would our national, economic and commercial prospects be enhanced if more of us spoke French, German, Russian or Mandarin? Would we be in some way a better family of citizens, as the noble Baroness, Lady Benjamin, put it, if English was not our only tongue? Would our young people be somehow differentially smarter, more mentally agile-as the noble Lord, Lord Broers, said-and versatile if they mastered a foreign language rather than some other school or university discipline?
	In preparing to answer such questions, one must confront a stark and uncomfortable reality. The technological wonders of the age have had the effect of depressing the motivation of English-speaking people to learn other languages. The internet was born of English-speaking parents. The giant brands of Amazon, eBay and Facebook all started in America, and obviously had English as their first language. The attitude is: so many of us can communicate with others, run our businesses and buy the goods we want without needing to learn any Portuguese future perfect subjunctives or German substantives-why bother? Consider how easy it is online to have the contents of a website translated into English. You do not have to know how to conjugate; you just have to know how to click. There lies the road to complacency and marginalisation when it comes to the take-up of modern languages.
	On the other side, the incentives for others in the world to build their own English skills in order to prosper have never been sharper. As the noble and learned Baroness, Lady Butler-Sloss, pointed out, for millions English is the default second language. Therefore, psychologically and pragmatically, the drive to learn another language is, for us, naturally blunted. Of course, the question is whether leaning a foreign language would make us better people, a richer culture and a stronger society, socially and commercially. The answer has to be an emphatic yes.
	I am proud of the investment that my Government made in language teaching and research but I acknowledge that there is still much more to be done, despite the marvellous job undertaken by language teachers and lecturers across our education sector. They are working in a very challenging environment and attitudes need to change. No debate on modern languages should pass without our acknowledgement, as the noble Lord, Lord Hannay, has mentioned, of the work undertaken by our much missed friend and colleague Lord Dearing. I am sure he would, like me and other noble Lords today, have liked to ask the Government what the latest information that they can give us is on taking forward the primary curriculum in languages, given the lack of agreement between the parties immediately before the general election.
	I also ask the Minister-she may well answer in writing-about universities and the Chancellor's announcement last week that there was to be a cut in overall funding to the higher education sector of 40 per cent, including an estimated 75 per cent cut in funding for undergraduate teaching. What comfort can the Minister give modern foreign languages departments in universities about their future security? New life needs to be breathed into the teaching of modern foreign languages. We need a recovery programme, as the noble Baroness, Lady Coussins, put it, or a task force, as my noble friend Lord Harrison might put it. Are the Government up to the task?

Baroness Garden of Frognal: My Lords, I am delighted to have an opportunity to contribute to this debate, although I very much regret the circumstances that have caused me to stand in for my noble friend the Minister. I shall indeed convey your Lordships' good wishes to him. We hope to see him back in his place very soon. I also thank the noble Baroness for securing this debate. I pay tribute to all the work that she has done as chair of the All-Party Group on Modern Languages. I know that she has been a passionate advocate of modern languages for many years. I wholeheartedly share her concern over the continuing fall in the number of students taking them.
	Like the noble Baroness, Lady Benjamin, I wondered whether I should deliver this speech in French, but time was short. Like many noble Lords present today, I was fortunate enough to benefit from studying modern languages. I learnt French from the age of eight, when my family lived in Paris for three years. I went on to read French and Spanish at university. This was underpinned by Latin. I know that I am joined by many-but obviously not all-noble Lords in finding Latin both useful and fun. We have heard from the noble Lord, Lord Cobbold, and the noble Baronesses, Lady Sherlock and Lady Warnock, about the importance of learning languages when one is young and finding them fun. When the RAF posted my husband to Germany, I taught English and French in a German gymnasium. I managed to learn a little German in the process. I hope that I taught a little more French and English to my pupils, but who knows?
	Languages have a role not only in preparation for the world of work but in the rather more old-fashioned sense of learning being a good thing. I reassure the noble Baroness from the very start that the coalition Government are working to ensure that languages are given greater pre-eminence, following the very worrying decline in the number of pupils who have been taking them over the past 10 years or so. Over that period, the proportion of students entered for a GCSE in a modern foreign language declined from a high of nearly 79 per cent in 2000 to just 44 per cent last year. There has also been a decline in the number of A-level students taking modern languages and a fall in the number of undergraduates studying language degrees. You end up with a vicious circle whereby enthusiasts and teachers are not going back into schools to regenerate and keep the pool going.
	Do languages matter? After today's debate, I think that noble Lords are in no doubt about that-yes, indeed they do. Seventy-five per cent of the world's population do not speak English. The proportion of internet usage conducted in English fell from 51 per cent to 29 per cent between 2000 and 2009. The noble and learned Baroness, Lady Butler-Sloss, recounted a sad story about the lack of French among wine buffs. French was always a language that one needed to discuss wine and food; one learnt it for that reason, if for no other.
	Learning another language is important to the social and economic future of the country. A number of noble Lords commented on that. The noble Lord, Lord Hannay, made some very pertinent remarks about businesses needing graduates with the ability to hold conversations in other languages and who understand the cultural differences between the UK and other countries. This message is being made forcefully by a range of organisations, such as the CBI, the British Chambers of Commerce and expert bodies such as CILT, the National Centre for Languages. The noble Baroness, Lady Crawley, asked whether business would be enhanced by language skills. According to one estimate by the Cardiff Business School, a workforce with better language skills could allow businesses to contribute £21 billion more to the UK economy.
	Various academic studies have shown that language learners show greater cognitive flexibility-as the noble Lord, Lord Broers, said, people with language skills stay mentally sharper in old age-and are better at problem solving and that languages help to narrow the gap between rich and poor students' attainment and to reinforce English language skills. The noble Baronesses, Lady Hooper and Lady Sharp, referred to this important aspect of learning somebody else's language as a means of helping you to understand your own language that much better.
	What can we do about this? It is clear that we have a duty to ensure that as many pupils in this country as possible have the opportunity to benefit from language learning at school and from as early an age as possible. The coalition Government are committed to achieving this. Ministers are already working on measures to ensure that languages regain their pre-eminence within the national curriculum. My right honourable friend the Secretary of State for Education, Michael Gove, recently set out plans for an English baccalaureate, which was mentioned in the previous debate and in this one. As the noble Lord, Lord Jay, pointed out, this consists of core academic subjects, including a modern or ancient language, alongside English, mathematics, science and a humanity subject. The debate is still continuing on whether a modern or an ancient language should be compulsory. We feel that any school teaching Latin and ancient Greek would almost certainly be teaching a modern language as well. However, one may not be able to rely on that and certainly those points will be made strongly in the review.
	I hope that the noble Baroness, Lady Coussins, will welcome the commitment to review the national curriculum, which is designed to ensure that it meets its original intended purpose as a core national entitlement organised around subject disciplines. A number of noble Lords asked about the timing. We will be announcing the remit of that review later this year, but I take this opportunity to assure noble Lords that the study of languages in primary and secondary schools will form a very important part of those plans as we move forward.
	Any increase in teaching foreign languages in schools will bring additional demands in terms of language teachers and their training needs. We also need to consider whether foreign language teaching should continue in all primary schools, as noble Lords have pointed out. I welcome the fact that the noble Baroness, Lady Benjamin, is relaying the schemes in her university to encourage primary school teachers as regards language teaching. It was announced in June that the Rose curriculum would not be implemented, but the funding will, of course, continue for this financial year.
	We must look at steps to ensure that more students study foreign languages in higher education. The noble Lords, Lord Jay and Lord Hannay, mentioned the concerns expressed by our colleagues in Europe about the number of British students working in EU institutions whose effectiveness and careers are limited if they lack language skills. I am grateful to the Secretary of State for Foreign and Commonwealth Affairs, who has been clear about his desire to see more UK graduates taking up such positions in Europe and using their skills and influence to the benefit of the UK, the EU and the international community. As noble Lords may be aware, in order to encourage more British students to consider careers in the EU, an event took place at the Foreign and Commonwealth Office earlier this month, bringing together vice-chancellors, university careers services and languages staff to develop ideas on how to take that forward.
	It is encouraging that the take-up of languages among students studying for other degrees is on the rise, but we still need to do more to engage and enthuse students to study languages in more depth. The work that the noble Lord, Lord Broers, and others in universities are doing to link engineering with a foreign language is welcome and will expand the breadth of opportunities for the students who take up those programmes. We are working to increase British students' understanding of the world and its peoples through spending time abroad during the course of their studies, for example through increased UK participation in the European Commission's ERASMUS programme. I will also mention the programme at UCL referred to by the noble Baroness, Lady Sherlock, which insists on a modern language for undergraduates. Recently I was told by a friend that their child discovered an interest in French that they had never found before because they wanted to go to UCL to read a completely different discipline.
	Modern foreign languages remain classified as both strategically important and vulnerable subjects for which additional funding has been made available to ensure their continued availability. I refer to the Routes into Languages programme that the Minister for Universities and Science, David Willetts, supported earlier this year with additional funding, allowing consortia of schools, colleges and universities in each English region to carry on their activities until the end of the financial year.
	The decline in the number of students studying languages at university prompted the Higher Education Funding Council for England to invite Professor Michael Worton, Vice-Provost of University College, London, to undertake a review of the health of language provision in English universities last year. That review also has been mentioned and the recommendations are being taken forward.
	I will pick up on one or two points. Perhaps I may write to noble Lords in response to questions that I have not answered. The noble Baronesses, Lady Coussins, Lady Sharp and Lady Warnock, mentioned the Language Ladder. Funding has continued until this year. The contract is now coming to an end and we will need to consult further on it, because obviously the programme had tremendous benefits. Several noble Lords mentioned the late Lord Dearing. In a debate such as this, we all feel his legacy and pay tribute to him.
	The noble Lord, Lord Harrison, mentioned Beaconsfield and the language skills at GCHQ. The military has had an extremely good language school at Beaconsfield for many years, teaching all sorts of exotic languages, as well as the mainstream ones. I do not know the answer to the question that the noble Lord raised and I think that it would probably be best answered by another government department. I shall try to refer it to the relevant department for an answer. However, my understanding is that TA officers certainly also receive language training if their duties require it.
	My noble friend Lady Benjamin mentioned primary schools, and I think that I have already talked about the implications for those schools.
	In conclusion, I repeat that the Government are absolutely committed to restoring the pre-eminence of languages within schools and higher education. I thank the noble Baroness for giving us the opportunity to debate this most important area once again, and I also thank all noble Lords who have spoken so persuasively this afternoon. I know that I speak on behalf of my noble friend the Minister when I say that we look forward to working closely with the noble Baroness over the coming months to ensure that the curriculum review takes full account of the arguments that have been raised during this debate.

House adjourned at 5.50 pm.